Sex and Catheter Ablation for Ventricular Tachycardia: An International Ventricular Tachycardia Ablation Center Collaborative Group Study

David S. Frankel, Roderick Tung, Pasquale Santangeli, Wendy S. Tzou, Marmar Vaseghi, Luigi Di Biase, Koichi Nagashima, Usha Tedrow, T. Jared Bunch, Venkatakrishna N. Tholakanahalli, Raghuveer Dendi, Madhu Reddy, Dhanunjaya Lakkireddy, Timm Dickfeld, J. Peter Weiss, Nilesh Mathuria, Pasquale Vergara, Mehul Patel, Shiro Nakahara, Kairav VakilWilliam H. Sauer, David J. Callans, Andrea Natale, William G. Stevenson, Paolo Della Bella, Kalyanam Shivkumar, Francis E. Marchlinski

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Importance: Significant differences have been described between women and men regarding presentation, mechanism, and treatment outcome of certain arrhythmias. Previous studies of ventricular tachycardia (VT) ablation have not included sufficient women for meaningful comparison.

Objective: To compare outcomes between women and men with structural heart disease undergoing VT ablation.

Design, Setting, and Participants: Investigator-initiated, multicenter, observational study performed between 2002 and 2013, conducted by the International VT Ablation Center Collaborative Group, consisting of 12 high-volume ablation centers. Consecutive patients with structural heart disease undergoing VT ablation were studied. Structural heart disease was defined as left ventricular ejection fraction less than 55%, hypertrophic cardiomyopathy, or right ventricular cardiomyopathy, with scar confirmed during electroanatomic mapping.

Exposures: Catheter ablation.

Main Outcomes and Measures: Ventricular tachycardia-free survival and transplant-free survival were compared between women and men. Cox proportional hazard modeling was performed.

Results: Of 2062 patients undergoing ablation, 266 (12.9%) were women. Mean (SD) age was 62.4 (13.3) years and 1095 (53.1%) had ischemic cardiomyopathy. Compared with men, women were younger, with higher left ventricular ejection fraction and less VT storm. Despite this, women had higher rates of 1-year VT recurrence following ablation (30.5% vs 25.3%; P = .03). This difference was only partially explained by higher prevalence of nonischemic cardiomyopathy among women and was actually most pronounced among those with ischemic cardiomyopathy.

Conclusions and Relevance: In 12 high-volume ablation centers, women with structural heart disease have worse VT-free survival following ablation than men. Whether this is owing to differences in referral pattern, arrhythmia substrate, or undertreatment requires further study.

Original languageEnglish (US)
Pages (from-to)938-944
Number of pages7
JournalJAMA Cardiology
Issue number8
StatePublished - Nov 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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