Differences in catheter ablation of paroxysmal atrial fibrillation between males and females
Abstract
Background Catheter ablation (CA) has become a standard treatment for patients with atrial fibrillation (AF). However, gender-related differences associated with CA of paroxysmal AF (PAF) remain unclear.Methods We compared 1124 consecutive patients (mean age, 61 ± 10 years; male, n=864) with PAF scheduled for CA between the genders.Results Females were significantly older (p<0.0001), and had a lower body-mass-index (p=0.02), smaller left atrial dimension (LAD; p=0.04), larger LAD indexed by the body-surface-area (LADI; p<0.0001) and better left ventricular ejection fraction (p<0.0001) at baseline. Ischemic heart disease (p=0.007) was more frequent in males, whereas hypertrophic cardiomyopathy (p=0.007) and mitral stenosis (p=0.001) were more frequent in females. More additional procedures were performed to eliminate non-pulmonary vein foci in females than males (p<0.05), but those locations were similar between the genders. The incidence of procedure-related complications was similar between genders (p=0.73). Sinus rhythm was similarly maintained between females and males after the first CA (56.4% vs. 59.3% at 5 years, p=0.24), but was significantly lower in females after the last CA (76.5% vs. 81.3% at 5 years, p=0.007). More females did refuse multiple CA procedures (especially a second one) than males (37.8% in females vs. 27.4% in males, p=0.02). The age (HR, 0.98/y, p=0.01), duration of AF (HR, 1.04/y, p=0.0001), number of failed anti-arrhythmic-drugs (HR, 1.10, p=0.03) and LADI (HR, 1.89 per 10mm/m(2), p=0.001) were significantly associated with AF-recurrence in males, but not in females.Conclusions Specific differences and similarities between the genders were observed in PAF patients undergoing CA.
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All three studies identified through the search suggested that sex is not a significant modifier of dementia in individuals with AF.
“All three studies identified through our search suggested that sex is not a significant modifier of dementia in individuals with AF.88–90”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [88]
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- Authors
- Takigawa, M., Kuwahara, T., Takahashi, A., Watari, Y., Okubo, K., Takahashi, Y., Takagi, K., Kuroda, S., Osaka, Y., Kawaguchi, N., Yamao, K., Nakashima, E., Sugiyama, T., Akiyama, D., Kamiishi, T., Kimura, S., Hikita, H., Hirao, K., & Isobe, M.
- Affiliations
- Tokyo Medical and Dental University (JP)
- Yokosuka Kyosai Hospital (JP)
- Corresponding author
- Takigawa, Masateru
- ORCID
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 168
- Issue
- 3
- Pages
- 1984-1991
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2016095080
- Cited by
- 106
- References
- 26
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 6 · 2023: 8 · 2022: 13 · 2021: 6 · 2020: 10 · 2019: 7 · 2018: 12 · 2017: 11 · 2016: 9 · 2015: 7 · 2014: 3 · 2013: 1
- FWCI
- 4.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Biosense Webster
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- paroxysmal atrial fibrillation, catheter ablation, sex differences, atrial fibrillation recurrence, left atrial diameter, repeat ablation, sinus rhythm maintenance, procedural complications, antiarrhythmic drug failure, atrial remodeling, hypertrophic cardiomyopathy, mitral stenosis, ischemic heart disease, atrial fibrillation
- MeSH terms
- Atrial Fibrillation, Electrocardiography, Female, Follow-Up Studies, Humans, Japan, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Sex Factors, Stroke Volume, Tachycardia, Paroxysmal, Body Mass Index, Incidence, Survival Rate, Treatment Outcome, Catheter Ablation
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