Differences in Clinical and Functional Outcomes of Atrial Fibrillation in Women and Men

Piccini, Jonathan P.; Simon, Denis Fred; Steinberg, Benjamin A.; Thomas, Laine; Allen, Larry A.; Fonarow, Gregg C.; Gersh, Bernard J.; Hylek, Elaine M.; Kowey, Peter R.; Reiffel, James A.; Naccarelli, Gerald V.; Chan, Paul S.; Spertus, John A.; Peterson, Eric D.

doi:10.1001/jamacardio.2016.0529

Cited by 195 publications

(183 citation statements)

References 24 publications

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“…Given the higher prevalence of atypical AF symptoms in women, including anxiety, panic, and stress, many providers may not recognize symptomatic AF and instead attribute their patients’ symptoms to other causes . This challenge of diagnosis is further compounded by the described higher frequency of paroxysmal AF in many women, as was seen in our study population, which may result in underdiagnosis of women who are in sinus rhythm at the time of medical evaluation.…”

Section: Discussionmentioning

confidence: 83%

Gender differences in symptoms and functional status in patients with atrial fibrillation undergoing catheter ablation

Bazemore

Bolger

Sears

et al. 2018

Pacing Clinical Electrophis

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Background Catheter ablation improves symptoms and quality of life in patients with atrial fibrillation (AF); however, despite its benefit, women are less likely than men to undergo catheter ablation. Women with AF have been described to have more frequent and severe symptoms with a lower quality of life than men, and it is therefore unclear why women are less likely to undergo catheter ablation. We prospectively characterized gender differences in AF symptoms among men and women undergoing ablation at UNC using questionnaire data. Methods Functional capacity was assessed with the Duke Activity Status Index (DASI) and quality of life was assessed with the Canadian Cardiovascular Society Symptoms of AF score (CCS‐SAF) and the AF Effect on Quality‐of‐Life Questionnaire Tool (AFEQT). Results Among 191 patients in the study, women were less likely to undergo catheter ablation and had higher rates of paroxysmal AF and higher CHADS2‐VASc scores than men. Women had a worse functional capacity with significantly lower DASI scores than men; quality of life was also worse among women, with higher CCS‐SAF scores and lower AFEQT scores than men. After adjustment for AF type, there was a persistent gender difference for functional capacity and symptom measures. Conclusions At the time of catheter ablation, women with AF had a significantly lower functional status with worse symptoms and a lower quality of life than men. The role of this symptom difference on the gender gap in enrollment for catheter ablation is unclear and likely due to multiple patient and provider factors.

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Section: Discussionmentioning

confidence: 83%

Gender differences in symptoms and functional status in patients with atrial fibrillation undergoing catheter ablation

Bazemore

Bolger

Sears

et al. 2018

Pacing Clinical Electrophis

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“…Since non-linear relationship between continuous BNP and MACNE and major bleeding was observed (figure 1B,C), continuous BNP was included in the models as a log-transformed continuous variable. Models were adjusted for all covariates listed in the online supplementary eAppendix 2 that were identified by backward selection with a retention criterion of α=0.05 using candidate variables listed in the online supplementary eAppendix 3 as starting covariates in the previous study 19. Importantly, to account for HF status, systolic and diastolic blood pressure, heart rate, New York Heart Association class and left ventricular ejection fraction were included in the models.…”

Section: Methodsmentioning

confidence: 99%

B-type natriuretic peptide, disease progression and clinical outcomes in atrial fibrillation

Inohara

Kim

Pieper

et al. 2018

Heart

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“…Studies exploring patients’ experiences from a gender and age perspective have shown considerable differences between women and men, as well as an impact of age in regard to the effect of arrhythmia on symptoms and HRQoL. There are studies with data from AF‐specific questionnaires, those who have made use of generic and domain‐specific questionnaires and those using a combination of questionnaires . Generic and domain‐specific questionnaires allow for comparisons between patients with different diagnoses while the advantage with a disease‐specific is that it adds specific, disease‐related information …”

Section: Introductionmentioning

confidence: 99%

Gender and age differences in symptoms and health‐related quality of life in patients with atrial fibrillation referred for catheter ablation

Walfridsson

Hansen²,

Charitakis

et al. 2019

Pacing Clinical Electrophis

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Background Primary indication for catheter ablation of atrial fibrillation (AF) is to reduce symptoms and improve health‐related quality of life (HRQoL). There are data showing differences between the genders and between younger and older patients. To evaluate this, we studied a large Scandinavian cohort of patients referred for catheter ablation of AF. Methods Consecutive patients filled out the ASTA questionnaire, assessing symptoms, HRQoL, and perception of arrhythmia, prior to ablation. Patients were recruited from four Swedish and one Danish tertiary center. Results A total of 2493 patients (72% men) filled out the ASTA questionnaire. Women experienced eight of the nine ASTA scale symptoms more often than men. Patients <65 years reported four symptoms more often, only tiredness was more frequent in those ≥65 years (P = .007). Women and patients <65 years experienced more often palpitations and regarding close to fainting and this was more common among women, no age differences were seen. Women and men scored differently in 10 of the 13 HRQoL items. Only negative impact on sexual life was more common in men (P < .001). Older patients reported more negative influence in four of the HRQoL items and the younger in one; ability to concentrate. Conclusions Women experienced a more pronounced symptom burden and were more negatively affected in all HRQoL concerns, except for the negative impact on sexual life, where men reported more influence of AF. Differences between age groups were less pronounced. Disease‐specific patient‐reported outcomes measures (PROMs) add important information where gender differences should be considered in the care.

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Differences in Clinical and Functional Outcomes of Atrial Fibrillation in Women and Men

Abstract: clinicaltrials.gov Identifier: NCT01165710.

Cited by 195 publications

References 24 publications

Gender differences in symptoms and functional status in patients with atrial fibrillation undergoing catheter ablation

Gender differences in symptoms and functional status in patients with atrial fibrillation undergoing catheter ablation

B-type natriuretic peptide, disease progression and clinical outcomes in atrial fibrillation

Gender and age differences in symptoms and health‐related quality of life in patients with atrial fibrillation referred for catheter ablation

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