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

BACKGROUND Cardiac electrophysiology (EP) has few women phy-sicians. 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 oper-ators 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 annu-ally, 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 oper-ators who performed > 10 of any given EP procedure annually.