The odds of ICD use were 27 percent lower for black men, 38 percent lower for white women, and 44 percent lower for black women.
The study authors said they weren't sure why these discrepancies exist.
"We're unsure whether there are differences in patient preferences," Hernandez said. "One can imagine that possibly men may ask for defibrillators more often than women or ask to have aggressive therapies more often than women. Alternatively, when offered, women can turn them down more. We don't know."
It's also possible that physicians are more comfortable prescribing the devices for men because clinical trials have been done mostly in men, or they see men who have other risk factors for sudden death more often than women. There could also be system-wide or hospital inequities with women having less than full insurance coverage for ICDs.
In any event, one solution seems clear.
"We need to promote awareness about the use of defibrillators, we need to figure out what are the barriers for use and, specifically, what are barriers for use in women and minorities and how to address these barriers," Hernandez said.
The Heart Rhythm Society has more on ICDs.
SOURCES: Adrian F. Hernandez, M.D., assistant professor, medicine, Duke Clinical Research Institute, Durham, N.C.; Wojciech Zareba, M.D., Ph.D., professor, medicine, cardiology unit, University of Rochester Medical Center, Rochester, N.Y.; Oct. 3, 2007, Journal of the American Medical Association
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