Effectiveness and safety of atrial fibrillation ablation in females

Abstract

Background Existing data on the effectiveness and safety of atrial fibrillation (AF) ablation in females are limited to studies of small sample size, lacking longer term follow‐up or adjustment for potential confounders. Methods A total of 6421 patients (2072 females) undergoing a first AF ablation procedure after enrollment in the Chinese Atrial Fibrillation Registry (China‐AF) study between August 2011 and December 2017 were analyzed. We evaluated the effectiveness (recurrence of documented [symptomatic or not] atrial tachyarrhythmia (AT)) and the safety (incidence of procedure‐related complications) of AF ablation in female patients compared to male patients. Sensitivity analyses based on routine data were also utilized to avoid potential sex differences in reporting of AF symptoms. Results Females were about 5 years older than males at the time of ablation (mean age 63.4 ± 9.5 vs 58.3 ± 10.8, P < .0001). A higher proportion of female patients had paroxysmal AF (74.3% vs 56.7%, P < .0001), hypertension (69.7% vs 61.3%, P < .0001), and hyperlipidemia (57.2% vs 52.9%, P = .001). Female sex was found to be an independent risk factor of AT recurrence in multivariate analyses (HR = 1.26, 95% CI 1.15‐1.38, P < .0001). These findings were confirmed in sensitivity analyses using only Holter data. Female sex was also associated with a higher risk of periprocedural complications after adjustment for baseline variables (OR = 1.41, 95% CI 1.03‐1.94, P = .03). Conclusions Female sex is an independent risk factor of AT recurrence and periprocedural complications after AF ablation.

Sex differences and temporal trends in hospitalization for catheter ablation of non-valvular atrial fibrillation: a single-center experience for 15 years

“…Kaiser et al reported that women had a high risk of vascular complication, hemorrhage, and cardiac tamponade compared to men during the procedure [7]. Data from the Chinese Atrial Fibrillation Registry also showed that women had more vascular complications [8]. In the present study, we focused on in-hospital mortality, which was 0.01% and 0.03% for men and the women, respectively, that did not signi cantly change during the study period.…”

Sex Differences and Temporal Trends in Hospitalization for Catheter Ablation of Nonvalvular Atrial Fibrillation: A Single-Center Experience for 15 Years

“…Kaiser et al reported that women had a high risk of vascular complication, hemorrhage, and cardiac tamponade compared to men during the procedure [ 7 ]. Data from the Chinese Atrial Fibrillation Registry also showed that women had more vascular complications [ 8 ]. In the present study, we focused on in-hospital mortality, which was 0.01% and 0.03% for men and the women, respectively, that did not significantly change during the study period.…”

Effectiveness and Safety of DOACs in Atrial Fibrillation Patients Undergoing Catheter Ablation: Results from the China Atrial Fibrillation (China-AF) Registry

“…CA can proceed only when no left atrial thrombi have been detected by pre-ablation transesophageal echocardiography (TEE) within 48 h. During the procedure, patients received intravenous unfractionated heparin interrupted to achieve a target activated clotting time (ACT) of 300 to 350 s. The detailed ablation strategy has been described previously. 17 Circumferential pulmonary vein isolation was achieved in all of the included patients. Left atrial linear ablation and/or complex fractionated atrial electrograms were also performed for patients with non-paroxysmal AF.…”