Women Get Less Aggressive Heart Therapy

Cardiologists treat arrhythmias much later, study finds

WEDNESDAY, Sept. 17, 2003 (HealthDayNews) -- A new study adds one more entry to a long list of heart conditions for which women are less likely to be given the same aggressive treatment accorded to men.

In this case, the treatment is radiofrequency catheter ablation therapy, used for many different abnormalities of heart rhythm. The study finds women with the same severe symptoms as men are referred an average of 28 months later than men for the treatment, says a report in the Sept. 17 issue of the Journal of the American College of Cardiology.

"It is my personal opinion that this is another example of a tendency for more conservative treatment of women," says study author Dr. Nikolaos Dagres, a cardiologist at the Hospital of the Westfaelische Wilhelms-University in Muenster, Germany. "It probably has something to do with social opinions and habits."

His paper cites a number of studies of different cardiac conditions and treatments, ranging from heart attacks to bypass surgery, showing that women get less intensive treatment than men.

In radiofrequency ablation, a catheter is threaded through a blood vessel in the heart so high-frequency radio waves can eliminate the cells causing an abnormal heart rhythm. In many cases, drug treatment is tried first.

The study looked at 894 patients who had the treatment at the university during a 43-month period. Matching men and women with the same conditions and symptoms, it finds not only the 28-month delay in giving women ablation treatment, even though they had more frequent bouts of abnormal heart rhythms than men who received the therapy.

The women also had been prescribed more drugs for the condition than the men, and more of them reported more than one episode of symptom-causing heart rhythm abnormality a month -- 80 percent of the women compared to 70 percent of the men.

There was no obvious medical reason to defer ablation therapy for the women, Dagres says.

"There is no difference in the success rates, no difference in complication rates and no difference in recurrence rates, so the outcome is the same in both sexes. But women are referred [for ablation therapy] later than men," he says.

Closer examination of patient records shows the gender difference in referral time occurred almost entirely in patients, male and female, who had normal electrocardiograms, despite their heart rhythm problems.

"My explanation for this is that when people have an abnormal electrocardiogram, the possibility for physician bias does not exist," Dagres says.

More information

The basics about women and heart disease can be found at the American Heart Association, which also has a page on arrhythmia.

SOURCES: Nikolaos Dagres, M.D., cardiologist, Hospital of the Westfaelische Wilhelms-University, Muenster, Germany; Sept. 17, 2003, Journal of the American College of Cardiology
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