Electrical Explanation for Gender Differences
The fact that heart of a woman is electrically wired differently from men should come as no surprise. The development of every part of the body is determined genetically, and modified by the sex hormones. The heart works through an electrical system that we can measure on the surface with the ECG.
Women Have a Faster Baseline Heart Rate than Men
On an average, women tend to have a faster baseline heart rate than men. This difference is seen in girls, as young as five years old.
Women’s ECG Readings may be Different
Women are more likely than men to be seriously affected by either congenital or acquired QT (a segment in ECG) prolongation which puts them at an increased risk for drug-induced torsades de pointes (a life threatening arrhythmia). The hormone (androgen and estrogen) levels may explain the gender differences in QT interval. Caution to be used in women when prescribing drugs like antibiotics, antifungals, antidepressants, anticonvulsants and antiarrhythmics that can precipitate QT prolongation as a side effect. It is not unusual to find congenital long QT syndrome as a cause of syncope and sudden death in young women.
Differences in abnormal heart rhythms in men and women
Delayed or missed diagnosis of an arrhythmia is a significant problem for women. Often, symptoms can be mistaken for other conditions including panic, stress, and anxiety and are usually not evaluated as cardiac problems.
- PSVT – a rapid heart rate that originates from upper chamber of heart is more commonly seen in women, completely curable but commonly “missed” diagnosis.
- Sinus Node Dysfunction – a slow heart rhythm that originates once the main pacemaker of heart becomes diseased, more commonly seen in women but often diagnosed late.
- Atrial fibrillation - One of the most common irregular heart rhythms in women associated with valvular heart disease and an increased risk for stroke and cardiovascular death as compared to men older than age 75. However, women are less likely to receive anticoagulation and ablation procedures compared to men.
- Sudden cardiac death (SCD) - It is a sudden, unexpected death caused by loss of heart function. SCD occurs almost as frequently in women as men and is related to about 400,000 deaths per year in women worldwide. It has been seen that while the majority of women who had SCD had no prior history of cardiac disease before death, they had at least one cardiac risk factor (smoking, hypertension or diabetes). Family history also played a role in increased risk if one parent died of heart disease before age 60. The majority of SCD in women was related to an abnormality of the heart rhythm (88%). This reinforces the need for careful screening of heart disease risk factors in women and managing these concerns even without symptoms being present.
- Paradoxical Scenario-Both men and women have been shown to derive an equal survival benefit from implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy (CRT) (both devices used in heart failure scenario), although these devices are significantly underutilized in women. Women also appear to have a better response to cardiac resynchronization therapy in terms of reduced numbers of hospitalizations and more robust reverse ventricular remodeling. Electrophysiologists are cardiologists with extensive specialized training in the diagnosis and treatment of heart rhythm problems. Electrophysiology department at Max Healthcare Superspeciality Hospital, New Delhi headed by a Women Cardiac Electrophysiologist, Dr Vanita Arora performs over 1000 procedures every year and the program has grown into one of the most experienced lab in the country. We have become the "go to" resource within the field of arrhythmia management and care.