Arrhythmias
² Unita Operativa di Cardiologia, Ospedale Guglielmo da Saliceto, Piacenza
³ Cardiologia Ambulatoriale ASL NAPOLI 3 SUD – ASL SALERNO
Abstract
The present paper provides an analysis of the main arrhythmias, focusing on sex and gender differences in anatomy, electrophysiology, epidemiology, and clinical presentation. Women exhibit distinct cardiac electrophysiological properties, including higher intrinsic heart rates, shorter sinus node recovery times, and longer corrected QT intervals, largely influenced by hormonal fluctuations throughout life. Female-specific risk factors, such as menstrual cycle variations, pregnancy, and menopause, significantly affect arrhythmia susceptibility and clinical management. Women are more prone to arrhythmias related to late repolarization, such as long QT syndrome and Torsades de Pointes, while men more frequently develop early-phase reentrant arrhythmias like atrial fibrillation and sort QT syndrome. The authors discuss the impact of hormonal changes on arrhythmia risk during different life stages, highlighting the need for tailored pharmacological and non-pharmacological therapies. Women experience higher rates of adverse drug reactions and require personalized monitoring, especially during pregnancy and menopause. Diagnostic approaches, including ECG interpretation, must account for sex-specific differences in waveforms and intervals. The prevalence and clinical course of supraventricular and ventricular arrhythmias, as well as bradyarrhythmias, are examined, with emphasis on the influence of non-cardiac conditions such as electrolyte imbalances, neurological disorders, and nutritional deficiencies. The document underscores the importance of lifestyle modifications, education, and awareness in prevention and management, advocating for gender-sensitive strategies to improve outcomes. It also calls for greater representation of women in clinical studies and the development of personalized medical approaches that consider hormonal influences and life transitions. Integrating these perspectives is essential for advancing equitable and effective arrhythmia care for women.
Key words: Women; Arrhythmias; Sex and Gender Differences; Hormonal Influences; Channelopathies; Sudden Death; Cardiac Arrest; Non-Pharmacological Therapy.
