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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.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

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

doi

10.1016/j.ijcard.2012.12.101

subject

Has Abstract

pub_date

2013-10-03 00:00:00

pages

1984-91

issue

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(13)00012-0

journal_volume

168

pub_type

杂志文章

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Differences in catheter ablation of paroxysmal atrial fibrillation between males and females.