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  • Title: Differences in catheter ablation of paroxysmal atrial fibrillation between males and females.
    Author: 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.
    Journal: Int J Cardiol; 2013 Oct 03; 168(3):1984-91. PubMed ID: 23782910.
    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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