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Article Dans Une Revue JACC: Clinical Electrophysiology Année : 2022

Sex Differences in Outcomes of Tetralogy of Fallot Patients With Implantable Cardioverter-Defibrillators

1 PARCC (UMR_S 970/ U970) - Paris-Centre de Recherche Cardiovasculaire
2 Parly II Private Hospital, Le Chesnay,
3 CHU Pitié-Salpêtrière [AP-HP]
4 TIMONE - Hôpital de la Timone [CHU - APHM]
5 Hôpital Louis Pradel [CHU - HCL]
6 CHU Caen
7 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
8 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
9 Service Cardiologie [CHU Toulouse]
10 Service de Cardiologie [CHRU Nancy]
11 CHU de Bordeaux - Centre Hospitalier Universitaire de Bordeaux
12 CHU Amiens-Picardie
13 Groupe hospitalier de La Rochelle
14 CHU Rouen
15 GHBS - Groupe Hospitalier Bretagne Sud
16 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
17 Clinique Pasteur [Toulouse]
18 Centre Hospitalier Princesse Grace
19 Hôpital saint Pierre, GH Sud Réunion
20 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
21 Centre hospitalier de Pau
22 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
23 Hôpital Henri Mondor
24 CHU Clermond Ferrand
25 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
26 CHU Dijon
27 CHU Limoges
28 Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois]
29 HEGP - Hôpital Européen Georges Pompidou [APHP]
30 CHA - Centre hospitalier d'Auxerre
31 Clinique Saint Pierre, Perpignan
32 CHU - BREST - Hôpital de la Cavale Blanche - CHRU Brest
33 CIC Hôpital Bichat
34 Centre Hospitalier Chalon-sur-Saône William Morey
35 CHU Trousseau [Tours]
36 Hôpital privé les Franciscaines
37 CHU Bordeaux
38 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
39 Clinique Saint Gatien
40 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
41 LTSI - Laboratoire Traitement du Signal et de l'Image
42 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
43 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
Fabien Labombarda
  • Fonction : Auteur
Alexis Hermida
Frédéric Anselme
  • Fonction : Auteur
Charles Guenancia
Benoit Guy-Moyat
  • Fonction : Auteur
Anne Messali
  • Fonction : Auteur
Frédéric Sacher
  • Fonction : Auteur
Jean-Benoit Thambo
  • Fonction : Auteur

Résumé

Background: Women with congenital heart disease at high risk for sudden cardiac death have been poorly studied thus far.Objectives: The aim of this study was to assess sex-related differences in patients with tetralogy of Fallot (TOF) and implantable cardioverter-defibrillators (ICDs).Methods: Data were analyzed from the DAI-T4F (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator) cohort study, which has prospectively enrolled all patients with TOF with ICDs in France since 2010. Clinical events were centrally adjudicated by a blinded committee.Results: A total of 165 patients (mean age 42.2 ± 13.3 years) were enrolled from 40 centers, including 49 women (29.7%). Among the 9,692 patients with TOF recorded in the national database, the proportion of women with ICDs was estimated to be 1.1% (95% CI: 0.8%-1.5%) vs 2.2% (95% CI: 1.8%-2.6%) in men (P < 0.001). The clinical profiles of patients at implantation, including the number of risk factors for ventricular arrhythmias, were similar between women and men. During a median follow-up period of 6.8 years (IQR: 2.5-11.4 years), 78 patients (47.3%) received at least 1 appropriate ICD therapy, without significant difference in annual incidences between women (12.1%) and men (9.9%) (HR: 1.22; 95% CI: 0.76-1.97; P = 0.40). The risk for overall ICD-related complications was similar in women and men (HR: 1.33; 95% CI: 0.81-2.19; P = 0.30), with 24 women (49.0%) experiencing at least 1 complication.Conclusions: Our findings suggest that women with TOF at high risk for sudden cardiac death have similar benefit/risk balance from ICD therapy compared with men. Whether ICD therapy is equally offered to at-risk women vs men warrants further evaluation in TOF as well as in other congenital heart disease populations. (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator [DAI-T4F]; NCT03837574)
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Dates et versions

hal-03825249 , version 1 (23-10-2022)

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Victor Waldmann, Abdeslam Bouzeman, Guillaume Duthoit, Linda Koutbi, Francis Bessière, et al.. Sex Differences in Outcomes of Tetralogy of Fallot Patients With Implantable Cardioverter-Defibrillators. JACC: Clinical Electrophysiology, 2022, 8 (10), pp.1304-1314. ⟨10.1016/j.jacep.2022.06.024⟩. ⟨hal-03825249⟩
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