Gender Differences in Ventricular Tachyarrhythmia Events in the Raid Trial

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Conference Proceeding

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Heart Rhythm


Background: Women have previously shown to be at a lower risk of ventricular tachyarrhythmia (VT) events in ICD trials, however, more contemporary data on the risk of VT/VF by gender, utilizing uniform, novel ICD programming are lacking. Objective: We aimed to assess gender differences in VT/VF events treated with ATP or treated with shock, and all-cause mortality in the RAID trial. Methods: The RAID trial enrolled high-risk ICD patients with ischemic or non-ischemic cardiomyopathy randomized to ranolazine or placebo. ICD programming was pre-specified with VT zone 190-220 bpm with 1 ATP and shocks and VF zone >220 bpm with shocks. Gender differences in VT/VF requiring ATP or shock were evaluated using Kaplan-Meier analysis and Cox models in an intention to treat analysis. All VT/VF episodes were centrally adjudicated. Results: There were 186 women (18%) out of 1012 subjects enrolled in RAID trial. Women were younger (61 vs. 65 years, p<0.001), more often non-ischemic (71% vs. 40%), p<0.001), they less often had diabetes (25% vs. 35%, p=0.007), and they had a shorter QRS duration (121 vs. 133 ms (p<0.001). Compared to men, women were at a significantly lower risk of VT/VF/Death (HR=0.70, p=0.046), a lower risk of VT/VF (HR=0.60, p=0.016), a lower risk of VT/VF treated with ATP (HR=0.56, p=0.02), and a lower risk of VT/VF treated with shock (HR=0.44, p=0.007) (Figure). The risk of mortality was similar between men and women (HR=0.78, p=0.421). Conclusion: High-risk women implanted with an ICD or a CRT-D in the RAID trial were found to be at a significantly lower risk of VT/VF/death, VT/VF, VT/VF requiring ATP or shock when compared to men. However, both men and women had a similar risk of mortality.





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