Women with PSVT are often misdiagnosed, referred later than men, and have more symptoms after ablation

Figures & data

Table 1. Baseline characteristics of the study subjects.

	Total n = 214	Men n = 105	Women n = 109	p
Age, mean ± SD	54 ± 15	56 ± 14	52 ± 15	.05
systolic blood pressure, mean ± SD	132 ± 19	137 ± 21	128 ± 18	.001
diastolic blood pressure, mean ± SD	78 ± 10	80 ± 11	76 ± 9	.002
Diagnosis	n (%)	n (%)	n (%)	p
AV nodal re-entrant tachycardia	175 (82)	81(77)	94(86)	.1
AV re-entrant tachycardia	25 (12)	16 (15)	9 (8)	.1
Focal atrial tachycardia	14 (7)	8 (8)	6 (6)	.6
Comorbidities
Heart disease*	13 (6)	8 (8)	5 (5)	.4
Diabetes	17(8)	11 (10)	6 (6)	.2
Hypertension	49 (23)	34 (32)	15 (14)	.002
Stroke/transient ischemic attack	7 (3)	4 (4)	3 (3)	.7
Impaired renal function	5 (2)	3 (3)	2 (2)	.7
Chronic obstructive pulmonary disease	9 (4)	4 (4)	5 (5)	1.0
Tested antiarrhythmic drugs
Beta-blockers	108 (50)	49 (47)	59 (54)	.7
Flecainide	2 (<1)	2 (2)	0	.2
Dronedarone	2 (<1)	2 (2)	0	.2
Sotalol	7 (3)	1 (<1)	6 (6)	.1
Calcium channel blockers	14 (7)	5 (5)	9 (8)	.4

*Coronary artery disease, cardiomyopathy, heart failure, valvular heart disease.

Table 2. Referral data, presented as n (%).

	Total n = 214	Men n = 105	Women n = 109	p
Referring unit
Emergency department	61 (29)	34 (32)	27 (25)	.2
Hospital	117 (55)	58 (55)	59 (54)	.9
General practitioner	8 (4)	4 (4)	4 (4)	1.0
Cardiac center outside the hospital	28 (13)	9 (9)	19 (17)	.1
Arrhythmia documentation prior to referral
Standard 12 lead ECG	129 (60)	66 (62)	63 (58)	.5
Noninvasive electrophysiology	13 (6)	6 (6)	7 (6)	1.0
Ambulatory ECG monitoring, external*	31 (14)	19 (18)	12 (11)	.2
Ambulatory ECG monitoring, internal*†	4 (2)	2 (2)	2 (2)	1.0
Exercise test	2 (<1)	1 (1)	1 (<1)	1.0
No documented arrhythmia	35 (16)	11 (10)	24 (22)	.03
Female physician has referred
Cardiologist	66 (59)	14 (37)	52 (69)	<.001
General practitioner	3 (3)	1 (3)	2 (3)	1.0
Specialist internal medicine	22 (19)	9 (24)	13 (17)	.5
Other specialist or unknown	22 (19)	14 (37)	8 (11)	.2
Total	113	38	75
Male physician has referred
Cardiologist	58 (57)	36 (54)	22 (65)	.02
General practitioner	6 (6)	3 (4)	3 (9)	1.00
Specialist internal medicine	15 (15)	10 (15)	5 (15)	.2
Other specialist or unknown	22 (22)	18 (27)	4 (12)	.001
Total	101	67	34

*Holter, telemetry, event recorder, thumb ECG; *†implantable loop recorder, pacemaker.

Table 3. Results from the questionnaire regarding the patient’s own experience of the arrhythmia, symptom duration and referral history.

	Total n = 213	Men n = 104*	Women n = 109	p
Questions and claims
“How many years have you experienced symptomatic arrhythmia?” mean ± SD	13 ± 14	10 ± 13	16 ± 15	.001
“Correct diagnosis was made at the first consultation” n (%)	94 (44)	53 (51)	41 (38)	.05
Experience at the Out-patient clinic
“How many times did you visit a GP, occupational health service or cardiologist due to the arrhythmia?” mean ± SD	3 ± 5	2 ± 4	3 ± 6	.1
“I didn`t feel that the health care staff believed in me at the consultation” n (%)	25 (12)	7 (7)	18 (17)	.03
Incorrect or no relevant diagnosis n (%)	43 (20)	17 (16)	26 (25)	.2
Of these: Stress, anxiety, depression n (%)	24 (11)	7 (7)	17 (16)	.05
Experience at the Emergency care
“How many times did you visit the Emergency care due to the arrhythmia?” mean ± SD	2 ± 3	3 ± 4	2 ± 3	.3
“I didn’t feel that the health care staff believed in me at the consultation” n (%)	11 (5)	4 (4)	7 (6)	.5
Incorrect or no relevant diagnosis n (%)	15 (7)	3 (3)	12 (11)	.03
Of these: Stress, anxiety, depression n (%)	3 (1)	2 (2)	1 (<1)	.6
Total incorrect or no relevant diagnosis (out-patient & emergency)	58 (27)	20 (19)	38 (35)	.01
Referral history
Referral for ablation at first consultation n (%)	91 (43)	40 (38)	51 (47)	.2
“I accepted when I was offered ablation for my arrhythmia symptoms!” n (%)	180 (85)	88 (85)	92 (84)	1.0
“I had wished to be referred for ablation earlier” n (%)	34 (16)	12 (12)	22 (20)	.1
“I had to ask for referral for ablation” n (%)	9 (4)	4 (4)	5 (5)	1.0
“I was offered a referral for ablation but wanted to wait” n (%)	24 (11)	12 (12)	12 (11)	1.0
Information
“I felt well informed how to act if a new arrhythmia episode should occur” n (%)	153 (72)	69 (66)	84 (77)	.1
“I would have liked more or better information about the arrhythmia” n (%)	54 (25)	32(31)	22(20)	.1

*One male did not answer the questions.

Table 4. Socioeconomic data from the additional questionnaire.

	Total n (%)	Men n (%)	Women n (%)	p
Marital status
Married	156 (73)	83 (80)	73 (66)	.04
Single	51 (24)	19 (18)	32 (29)	.1
Widowed	8 (4)	2 (2)	6 (5)	.3
Unknown	2 (<1)	2 (2)	0 (0)	.2
Education Level
Primary school	34 (16)	17 (16)	17 (15)	1.0
High school	88 (41)	45 (43)	43 (39)	.6
University/College	88 (41)	41 (39)	47 (43)	.7
Unknown	2 (<1)	2 (2)	0 (0)	.2
Occupational status
Employed	118 (55)	47 (45)	71 (65)	.004
Temporary work, hourly employee, student, unemployed	11 (5)	4 (4)	7 (6)	.5
Self-employed	30 (14)	24 (23)	6 (5)	<.001
Retired	47 (22)	27 (26)	20 (18)	.2
Long-term illness leave*	6 (3)	2 (2)	4 (4)	.7
Unknown	5 (2)	2 (2)	3 (3)	1.0
Annual income
<7 479 €	11 (5)	3 (3)	8 (7)	.2
7 480- 16 026 €	13 (6)	5 (5)	8 (7)	.6
16 027- 26 602 €	28 (13)	11 (11)	17 (15)	.3
26 603- 47 970 €	92 (43)	42 (40)	50 (45)	.5
47 971-69 338 €	35 (16)	21 (20)	14 (13)	.2
>69 338 €	21 (10)	17 (16)	4 (4)	.002
Unknown	17 (8)	6 (6)	11 (10)	.3
Ethnicity
Sweden or Nordic countries	174 (81)	85 (81)	89 (81)	1.0
Europe	7 (3)	3 (3	4 (4)	1.0
Middle East	3 (1)	2 (2)	1 (<1)	.6
South America	2 (<1)	0 (0)	2 (2)	.5
Asia	2 (<1)	2 (2)	0 (0)	.2
Unknown	26 (12)	12 (11)	13 (12	1.0

*more than three months, disability retirement.

Figure 1. Comparion of Health-Related Quality of Life (SF-36) at baseline compared to six months, all patients. PF: Physical functioning; RP: Role-Physical; BP: Bodily Pain; GH: General Health; VT: Vitality; SF: Social Functioning; RE: Role-Emotional; MH: Mental Health.

Figure 2. Comparison of Symptoms Checklist. Frequency scale between the sexes at baseline.

Figure 3. Comparison of Symptoms Checklist. Frequency scale between the sexes at six months.