Getting Into the Rhythm of Gender Parity in Electrophysiology

Mind the Gap! Working Toward Gender Equity in Pediatric and Congenital Heart Disease: Present and Future

Evidence from medicine and other fields has shown that gender diversity results in better decision making and outcomes. The incoming workforce of congenital heart specialists (especially in pediatric cardiology) appears to be more gender balanced, but past studies have shown many inequities. Gender-associated differences in leadership positions, opportunities presented for academic advancement, and recognition for academic contributions to the field persist. In addition, compensation packages remain disparate if evaluated based on gender with equivalent experience and expertise. This review explores these inequities and has suggested individual and institutional changes that could be made to recruit and retain women, monitor the climate of the institution, and identify and eliminate bias in areas like salary and promotions.

Gender Disparity in Work Distribution Among Cardiology Trainees: Pakistan's Perspective

Gender disparity in work distribution among cardiology trainees is a crucial issue that can impact career development and the overall representation of women in the field. This cross-sectional survey aimed to examine the gender disparity in work distribution among cardiology trainees in Pakistan. A total of 1156 trainees from various medical institutions across the country participated in the study, with 687 male trainees (59.4%) and 469 female trainees (40.5%). Demographic characteristics, baseline characteristics, work distribution patterns, perceptions of gender disparity, and career aspirations were assessed. The findings revealed that male trainees reported being assigned more complex procedures compared to female trainees (75% vs 47%, P < 0.001), while female trainees reported a higher frequency of being assigned administrative tasks compared to male trainees (61% vs 35%, P = 0.001). Both genders reported similar perceptions of the overall workload. However, female trainees experienced significantly higher rates of perceived bias and discrimination compared to male trainees (70% vs 25%, P < 0.001). Moreover, female trainees expressed a higher perception of unequal opportunities for career advancement due to gender disparities (80% vs 67%, P < 0.001). While male and female trainees showed similar aspirations for pursuing advanced subspecialties within cardiology, male trainees expressed a higher intention to pursue leadership positions within the field (60% vs 30%, P = 0.003). These findings shed light on the existing gender disparities in work distribution and perceptions within cardiology training programs in Pakistan.

Electrophysiology practice in low- and middle-income countries: An updated review on access to care and health delivery

Concurrent with the epidemiological transition to cardiovascular diseases in low- and middle-income countries (LMICs), the burden of arrhythmias is increasing significantly. However, registries of electrophysiological disorders and their management in LMICs are limited. The advancement of telemedicine technology can play a distinctive role in providing accurate diagnoses in resource-limited settings. The estimated pacemaker implantation requirements (1 million per year) demand an alternate source of pacemakers, including reused permanent pacemakers and implantable cardioverter-defibrillators. In addition, the majority of supraventricular tachycardias and atrial fibrillation can be managed with radiofrequency ablation, which not only is cost-effective but is curative for most patients.

Quantifying the impact of equity, diversity, and inclusion in electrophysiology: Training the first female electrophysiologists from Jamaica and Saint Lucia

Background

Delivery of electrophysiology (EP) care in developing nations and underserviced populations faces many hurdles, including the lack of local expertise and knowledge creation. The West Indies has experienced a paucity of local EP expertise. The University of Toronto has undertaken a unique collaborative educational effort with the University of the West Indies.

Objective

We describe the effects of equity, diversity, and inclusion (EDI) in EP training at Toronto General Hospital in Canada by quantifying the impact of training the first female electrophysiologists to practice in Jamaica and Saint Lucia.

Methods

Data from the ministries of health in Jamaica and Saint Lucia were reviewed. The number of arrhythmia clinic patients seen, EP studies and ablations performed, pacemaker clinic patients seen, and implantable devices, permanent pacemakers (PPMs), and implantable cardioverter-defibrillators (ICDs) implanted were assessed.

Results

One hundred one arrhythmia consults were seen by the new electrophysiologist in Jamaica after her return from training in 2020. She has since performed 19 EP studies/catheter ablations at a newly established ablation laboratory. Three cases of left ventricular (LV) dysfunction due to tachy-cardiomyopathy were treated successfully with catheter ablation with immense improvement in LV ejection fraction. Thirteen PPMs, 1 ICD, and 3 LV leads were implanted, after which no early complications were identified. In Saint Lucia, where there is no dedicated electrophysiology laboratory, 2 patients who required catheter ablation for tachycardia-mediated LV dysfunction were identified by the electrophysiologist since her return to the island in 2018. The patients were appropriately referred, resulting in restoration of normal LV function. Six PPMs also were implanted in Saint Lucia. Knowledge translation has been limited by the lack of accessibility to the required devices, catheters, and specialized equipment and accessories, mainly because of their costs.

Conclusion

Training the first female electrophysiologists from Jamaica and Saint Lucia led to a quantifiable impact on EP care in both of these Caribbean countries. EDI strategies in EP training programs provide much needed benefits to developing nations, but more support is needed to allow new electrophysiologists to fully utilize their EP training to care for underserviced populations.