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The Inequity of the Implantable Cardioverter-Defibrillator

Management of Hypertrophic Cardiomyopathy

What is hypertrophic cardiomyopathy? It’s a disease that causes abnormal thickening of the heart muscle, which leads to difficulty in blood pumping. It can cause arrythmias and death. Although both genders have a heart, women, along with people of color, are less likely to be implanted with a cardioverter-defibrillator as treatment. First author of the study published in Mayo Clinic Proceedings, Sri Harsha Patlolla, MBBS, a postdoctoral fellow in the Department of Cardiovascular Surgery at Mayo Clinic, stated, “Racial disparities exist in hypertrophic cardiomyopathy with regards to disease expression and worse outcomes. As with sex-specific differences, this could be the result of systemic bias with inequity of clinical care. The fact that ICD use is more common in large and teaching hospitals suggests that patients in smaller hospitals may not have access to specialists in hypertrophic cardiomyopathy management. Improving access to centers offering the highest level of specialized care may help reduce these disparities. How our findings relate to care access, socioeconomic status and patient-shared decision-making warrants further study."

The study concluded, “ICD devices are underused in women and racial minorities independent of demographics, hospital characteristics, and comorbidities. Women and racial minorities also had higher rates of complications and greater resource use compared with men and those belonging to the White race, respectively.”


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