Temporal and geographical trends in women operators of electrophysiology procedures in the United States

Heart Rhythm. 2022 May;19(5):807-811. doi: 10.1016/j.hrthm.2022.02.015.

Abstract

Background: Cardiac electrophysiology (EP) has few women physicians.

Objective: The purpose of this study was to determine temporal and geographical trends in the proportion of women EP operators in the United States.

Methods: We extracted data from the Medicare Provider Utilization and Payment Database from 2013 to 2019 using procedure codes for atrial fibrillation (AF) ablation, supraventricular tachycardia/atrial flutter (SVT/AFL) ablation, and cardiac device implantation. The Medicare Provider Utilization and Payment Database excludes operators who perform ≤10 procedures annually for a given individual procedure code. The proportion of women operators was compared across the 7-year period.

Results: On average annually between 2013 and 2019, 5% (n = 187) of the 3524 EP operators were women. Procedure-specific analyses demonstrated a similarly low proportion of women EP operators across each procedure type. Despite a 137% increase in the total number of AF ablationists over the 7-year period, the proportion of women remained unchanged (P = .3966). The number of SVT/AFL ablationists and device operators remained constant over time as did the proportion of women operators (P = .9709 and .3583, respectively). In 2019, 10 states (20%) had no women EP operators who performed >10 of any given EP procedure annually, 20 states (39%) had no women who performed >10 of either AF or SVT/AFL ablation procedures annually, and 10 states (20%) had no women device operators who performed >10 of any given type of device implantation annually.

Conclusion: Women EP operators remain underrepresented, and the proportion of women is stagnant even in areas of major clinical growth such as AF ablation. One-fifth of states had no women operators who performed >10 of any given EP procedure annually.

Keywords: Ablation; Device implantation; Disparity; Electrophysiology; Gender.

MeSH terms

  • Aged
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / surgery
  • Atrial Flutter* / epidemiology
  • Atrial Flutter* / surgery
  • Cardiac Electrophysiology
  • Female
  • Humans
  • Male
  • Medicare
  • Tachycardia, Paroxysmal*
  • Tachycardia, Supraventricular* / surgery
  • United States / epidemiology