Sex differences in idiopathic ventricular arrhythmias

Idiopathic ventricular arrhythmias (VAs), including ventricular tachycardias (VTs) and premature ventricular contractions, represent approximately 10% of VAs in clinical practice. The VAs arising from the right ventricular outflow tract in women were 1.5–2.0 times more frequent than those in men. The VAs arising from the septal portion of the tricuspid annulus and those from the ventricular crux are distributed equally between males and females. For the other VA origins (i.e., left ventricular (LV) fascicular VTs, LV papillary muscle VAs, etc.), there seems to be a male predominance. Thus, distinct sex differences are present in idiopathic VAs according to each origin of the VAs. The changes in the sex hormone levels and sex differences in those levels, distributions of ion channels, and/or the autonomic nervous system have been proposed to explain the sex differences in idiopathic VAs.