Europace Advance Access published online on July 18, 2007
Europace, doi:10.1093/europace/eum144
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Gender-related differences in catheter ablation of atrial fibrillation
1 Arrhythmia and Electrophysiology Center, St Ambrogio Clinical Institute, Via Luigi Faravelli, 16-20149 Milan, Italy; 2 Division of Cardiology, Cardiac Arrhythmia Center and Heart Failure Unit, St Camillo-Forlanini Hospital, Rome, Italy; 3 Department of Cardiology, University of Rome ‘Tor Vergata’, Rome, Italy; 4 Department of Cardiovascular Medicine, Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
Aims Women have an increased risk for atrial fibrillation (AF)-related complications and there is evidence towards a reduced efficacy of the rhythm control strategy than men. A catheter-based strategy is therefore widely attractive, but the impact of gender on catheter ablation (CA) of AF remains undefined.
Methods and results We included 221 consecutive patients (150 men) who underwent CA of drug-refractory AF. Gender differences in clinical presentation and outcomes were compared. Women were older (P = 0.002), had a longer history of AF (P = 0.04), and were more likely to have hypertension (P = 0.04). Moreover, a concomitant valvular heart disease tended to be more common in women (32.4 vs. 23.3%; P = 0.28) and left atrium dimensions were significantly larger (P = 0.003). However, acute success rate and complications rate were similar between genders. After 22.5 ± 11.8 months of follow-up, the overall freedom from arrhythmia recurrences was similar (83.1 vs. 82.7% in men), and a similar improvement in SF-36 quality of life scores was achieved in both groups.
Conclusion Women are referred for AF ablation later with a more complex clinical pre-operative presentation. Despite this higher risk profile in women, no differences were detected in clinical outcomes. Our findings indicate that CA of AF appears to be safe and effective in women as in men.
Key Words: Atrial fibrillation, Catheter ablation, Arrhythmia, Gender
* Corresponding author. Tel: +39 02 33127712 ext. 7713; fax: +39 02 33127038. E-mail address: forleo{at}tiscali.it
Manuscript submitted 7 August 2006. Accepted after revision 21 June 2007.
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