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Men are more likely than women to get a more expensive and sophisticated pacemaker, a study based on 36,000 Medicare patients finds. The report was published today in the journal of the of the American Heart Association. The study found that the pacemaker women were more likely to receive results in a death rate of 28.9 percent after two years; the other registered a rate of 22.3 percent. Sexual discrimination? Maybe -- but not necessarily so, says TIME medical writer Christine Gorman. Guidelines instruct physicians to implant the sophisticated pacemakers in younger and more active people, Gorman notes. "And women tend to develop heart trouble at more advanced ages," she says. "So it doesn't necessarily mean this is sexism."