Sex-specific short- and long-term outcomes in patients with leadless cardiac pacemakers.

Women represented only one-third of patients receiving leadless cardiac pacemakers in this cohort.

• 378 total LCPs were implanted: 127 women (33.6%) and 251 men (66.4%).
• This single-centre observational study assessed sex-specific short- and long-term outcomes.
• The underrepresentation of women may relate to differing indications between sexes.

Indications for LCP implantation differed significantly between sexes, with atrial fibrillation with slow conduction more common in men and sick sinus syndrome more common in women.

• Atrial fibrillation with slow conduction: women 31.5%, men 44.6%.
• Third-degree atrioventricular block: women 31.5%, men 33.5%.
• Sick sinus syndrome: women 21.3%, men 9.6%.

Procedure-related complications during LCP implantation occurred more frequently in women than in men.

• Procedure-related complications: women 3.1%, men 0.4%.
• All complications during the index stay: women 3.9%, men 1.6% (p = 0.18), indicating no statistically significant difference.
• Despite the numerically higher rate in women, the overall complication rate during index stay did not reach statistical significance.

In-hospital mortality was equally low in both sexes.

• In-hospital mortality was 0.8% in women and 0.8% in men (p = 0.96).
• No sex-specific disparity was observed for in-hospital mortality.

Concomitant lead extraction was the only independent predictor for complication or death during index stay.

• Multivariable logistic regression analysis was adjusted for sex, age, diabetes, chronic kidney disease, coronary artery disease, and transcatheter and surgical valve replacement.
• Concomitant lead extraction had an odds ratio of 9.153 (p = 0.001).
• Sex was not an independent predictor of complications or death during index stay in the adjusted analysis.

All-cause mortality during long-term follow-up did not differ significantly between women and men.

• All-cause mortality was 30.7% in women (n = 39) and 27.5% in men (n = 69, p = 0.28).
• Median follow-up was 41 months (IQR 22–65 months).
• No sex-specific disparity was observed for all-cause mortality.

Electrical performance parameters of LCPs were similar between sexes.

• No statistically significant sex-based differences in LCP electrical performance parameters were reported.
• This finding was consistent across both short- and long-term follow-up periods.