For years, doctors have observed a curious difference between men and women when it comes to heart rhythms.
Women tend to have faster heartbeats, while men are more likely to suffer from irregular heart rhythms like atrial fibrillation (AFib).
Now, a new study from The Ohio State University Wexner Medical Center has shed light on why this happens, uncovering that the differences may be rooted in the genetic makeup of the heart’s natural pacemaker, called the sinoatrial node (SAN).
The sinoatrial node is a tiny structure in the heart that controls its rhythm, acting as its natural pacemaker. It sets the pace for the heartbeat by sending out regular electrical signals that tell the heart when to contract.
The study, published in Circulation: Arrhythmia and Electrophysiology, found that the SAN operates on different genetic instructions in men and women.
These genetic differences affect how the heart beats and may explain why men and women experience different types of heart rhythm problems.
Dr. Vadim Fedorov, the senior author of the study and a professor of physiology and cell biology at Ohio State University, said that this is the first time researchers have discovered that the genes controlling how the SAN works are influenced by biological sex.
“That helps explain why women generally have faster heart rates and are more likely to experience inappropriate sinus tachycardia, while men face a greater risk of heart rate disorders like conduction block and atrial fibrillation,” Fedorov explained.
To uncover these differences, researchers at Ohio State’s Dorothy M. Davis Heart and Lung Research Institute and the Bob and Corrine Frick Center for Heart Failure and Arrhythmia studied human hearts donated for research through Lifeline of Ohio. The team closely examined the SAN cells that generate and maintain the heart’s rhythm.
They analyzed specific genes and pathways involved in pacing, metabolism, inflammation, and fibrotic remodeling. Fibrotic remodeling is a process where the heart tissue becomes thickened and scarred, which can interfere with electrical signals and lead to irregular heartbeats.
The findings revealed clear differences between male and female hearts. In women, two important genes—TBX3 and HCN1—were more active. These genes help drive faster heart rhythms, which may explain why women tend to have quicker heartbeats. In contrast, male hearts showed more activity in gene networks related to inflammation and collagen production.
This is important because excessive inflammation and collagen buildup can disrupt the heart’s electrical pathways, increasing the risk of arrhythmias like AFib. AFib is a condition where the heart beats irregularly and often rapidly, leading to poor blood flow and increasing the risk of stroke and heart failure.
Dr. Ning Li, a co-author of the study and a research assistant professor at Ohio State, explained that these findings are crucial for understanding how heart rhythm problems develop differently in men and women.
“Women showed higher levels of TBX3 and HCN1, which are two key genes that help drive faster heart rhythms,” Li said. “In contrast, male hearts had more activity in gene networks related to inflammation and collagen production, which can interfere with electrical signaling and increase the risk of arrhythmias.”
This study’s results could help pave the way for more personalized treatments for heart rhythm disorders. Right now, many treatments for heart conditions are the same for men and women, even though their hearts behave differently. Understanding these genetic differences might allow doctors to create more targeted therapies that match each patient’s specific genetic profile.
The research also ties into broader efforts at Ohio State to prevent common heart rhythm disorders that can cause the heart to beat too fast or too slowly. These conditions are not only dangerous but also often require medical interventions like medication or the implantation of a pacemaker.
The American Heart Association estimates that more than 6 million Americans are currently living with heart failure, and many of them also suffer from rhythm disturbances originating in the SAN. These irregular rhythms can significantly affect quality of life and increase the risk of severe complications.
Moving forward, the research team hopes their findings will encourage more studies into how men and women experience heart disease differently. With more detailed knowledge, doctors might be able to catch heart rhythm problems earlier and develop more effective treatments that are tailored to biological differences.
This discovery marks a significant step forward in understanding heart health and could eventually lead to new strategies for preventing and treating heart rhythm disorders in both men and women.
As researchers continue to explore how gender influences heart health, it may become possible to predict who is at higher risk for certain heart conditions and prevent them before they become life-threatening.
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For more information about heart health, please see recent studies about more coffee linked to heart rhythm disease, and results showing Zinc and vitamin B6 linked to lower death risk in heart disease.
The research findings can be found in Circulation: Arrhythmia and Electrophysiology.
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