Editors-in-Chief: Yong-Mei Cha, MD; Margaret A. Lloyd, MD; and Urika M. Birgersdotter-Green, MD
Publisher: Oxford University Press – 270 pages
Book Review by: Nano Khilnani

The editors and contributing authors of this book point out that women’s experiences have been different than men’s in problems and issues relating to heart disease. They write that women:

  • Have unique aspects involved in the diagnosis and treatment of arrhythmias and implantable device therapy.
  • Have historically been underrepresented in state-of-the art device trials and other clinical trials relating to managing arrhythmias.
  • Have unique biologic features of cardiac rhythm and dysrhythmia.
  • Have different indications than men for device therapy and device complications.
  • May or may not benefit from the same therapies to the same extent as men.

This book is not only an important, but an essential resource for cardiologists, clinicians, electrophysiologists, internists, and related health care professionals who seek to better diagnose and treat arrhythmias in their women patients. It provides an up-to-date review of the diagnosis and treatment of atrial and ventricular arrhythmias.

Twenty-five physicians from all over the United States contributed chapters to this book. They are professors at various schools of medicine and / or are involved in various aspects of cardiovascular disease in medical centers.

What subjects are covered in this book? They are the following, which are the titles of its 15 chapters:

  1. Sex Bias or Sex Disparities Among Women With Arrhythmias?
  2. Women in Clinical Trials
  3. Genetic and Hereditary Considerations for Arrhythmias in Women
  4. Sex-Specific Electrophysiologic Properties
  5. Supraventicular Arrhythmias
  6. Atrial Fibrillation in Women
  7. Drug Treatment in Women
  8. Sudden Cardiac Death in Women
  9. Implantable Cardioverter-Defibrillator Therapy in Women
  10. Pacing and Cardiac Resynchronization Therapy in Women
  11. Syncope and POTS: Are Women Really Faint of Heart?
  12. The Road to a Successful Women’s Heart Clinic
  13. Taking a Look Around the World
  14. Pregnancy and Arrhythmias
  15. Lead Extraction in Women

Each chapter is well organized with the following components:

  • Introduction
  • Discussions of Various Topics
  • Conclusion
  • References

Throughout the book you will find full-color charts, photos, and tables as study aids.

Perhaps the most important chapter to read first is No.8, Sudden Cardiac Death in Women. This chapter gives you sobering statistics. For example, more than one third or about 150,000 of the 450,000 people in the United States who are victims of sudden cardiac death (SCD) in a given year are women. This is more than twice the number of women who die of breast cancer annually.  And when death from coronary artery disease (CAD) is included with SCD, more women in the U.S. die of cardiovascular disease than of all types of cancer.

Globally, cardiovascular disease is the leading killer of women. And SCD is a killer with an unexpected nature. There are no warning signs to identify a person who may experience SCD, and consequently, little if any opportunity to intervene and prevent death.

The topics discussed in this chapter are:

  • Etiologies of SCD: Sex Differences in Arrhythmic Substrate
  • Potential Sex Differences in the Triggering of Ventricular Arrhythmias
  • Risk Stratification
  • Risk Reduction

The Summary of this chapter states that SCD continues to be a big health problem with few solutions in sight. While women who experience SCD are about one-third likely to die of it than men, cardiovascular disease (including SCD) is the number one killer of women. The differences between men and women who have arrhythmia, as well as their age, make the problem even more difficult to solve.

The good news is that SCD is being investigated more than ever before. The bad news however is that present-day guidelines for preventive intervention apply to only a small part of the population at risk, and only small numbers of women are invited to participate in studies designed to gather more data to understand the problem in greater detail and depth. But researchers are putting in more effort than ever before to better understand SCD in women and the overall cardiovascular process.

This is a good book on cardiovascular disease in general and arrhythmias in particular in women. The subject of SCD is narrow in scope, but it is very important because it kills about 150,000 women annually, and much is not known about its causes. Its broader scope – the study of overall cardiovascular disease in women – may also help understand SCD in women better than we currently know.


Yong-Mei Cha, MD is Consultant and C0-Director of the Implantable Cardiac Device Service; he is affiliated with the Division of Cardiovascular Diseases; and Professor of Medicine at the Mayo Clinic College of Medicine in Rochester. Minnesota.

Margaret A. Lloyd, MD, MBA is Consultant at the Division of Cardiovascular Diseases, and Assistant Professor of Medicine at the Mayo Clinic College of Medicine in Rochester, Minnesota.

Urika M. Birgersdotter-Green, MD is Director of Pacemaker and ICD Services at the University of California, San Diego Health Sciences; and Professor of Medicine at UC – San Diego School of Medicine in San Diego, California.