Gender Bias Trends in Implantable Cardioverter-Defibrillator Therapy

The use of implantable cardioverter defibrillator (ICD) therapy for primary prevention in patients with heart failure (HF) and left ventricular systolic function less than 35 % has a known benefit in preventing sudden cardiac death. Despite evidence-based practice guidelines including class I recommendations from major cardiology associations, many eligible patients are not receiving ICDs. Furthermore, there is an apparent gender-based disparity such that women are receiving ICDs far less than men. This is evident from review of data regarding ICD utilization over the last 10 years. The advent of programs such as GWTG-HF and IMPROVE-HF has improved monitoring and adherence to guideline-based therapy. However, review of recent temporal trends in ICD use in eligible patients has revealed that while overall utilization has improved and the gender gap has been significantly narrowed, a gender-based disparity still persists. This review outlines gender disparities in ICD therapy, temporal trends, and future endeavors to further address the differences.