Gender differences in implantable cardioverter-defibrillator patients at the time of insertion.

Gender differences in physical and psychological health and responses in persons receiving implantable cardioverter-defibrillators (ICDs) have been reported but are not well delineated. This study examined symptoms of pain and sleep difficulties, functional status, and psychological responses in 180 (75%) men and 60 (25%) women before and immediately following their first ICD implantation. Women were significantly younger, less likely to be married, and had less history of coronary artery disease than men. Forty-eight percent of women were New York Heart Association class III-IV vs. 27% of men (p<0.05). Women had lower functional status and were more likely to report symptoms of increased pain severity and sleep difficulties. Differences in functional status and pain were reduced after adjusting for New York Heart Association class and age, respectively. There were no differences in depressive symptoms or anxiety. Clinical implications of gender-related responses include the need to address symptoms of heart failure as well as increased pain and sleep difficulties in women at the time surrounding ICD implantation. Longitudinal studies and gender-focused nursing interventions should be developed to promote better understanding of responses and to improve recovery outcomes for ICD patients.