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Sex Differences in Predictors of Recurrence after Catheter Ablation in Patients with Persistent Atrial Fibrillation

SSRN Electronic Journal
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Metric Options:   Counts1 Year3 Year

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  • Usage
    220
    • Abstract Views
      193
    • Downloads
      27

Article Description

Background: Atrial fibrillation (AF) is a progressive disease, and patients with persistent AF (PeAF) have consistent long-term recurrences after AF catheter ablation (AFCA). We explored the possible sex-related differences in the recurrence predictors in patients with PeAF who had a recurrence within 3 years after AFCA. Methods: Among 3985 consecutive patients who underwent a de novo AFCA and protocol-based rhythm follow-up, we evaluated the predictors of an AF clinical recurrence within 3 years (CR-3yr) of the AFCA in 1387 patients with PeAF (men: 78.4%, 59.510.5 years old), in relation to the sex of the patients. Results: The left atrial (LA) dimension (hazard ratio [HR] 1.04 [1.02-1.06], p=0.001) and LA voltage (HR 0.71 [0.58-0.87], p=0.001) were independently associated with a CR-3yr of the AFCA of PeAF. Among 1088 men, the LA dimension (HR 1.04 [1.01-1.07], p=0.006), an epicardial adipose tissue (EAT) volume ≥ the median (HR 1.37 [1.04-1.80], p=0.025), and LA voltage (HR 0.64 [0.51-0.80], p<0.001) were independent predictors of a CR-3yr. In 299 women, diabetes was independently associated with a CR-3yr (HR 0.48 [0.25-0.93]), p=0.03). There were significant interactions between the sex and effects of the age (P for interaction=0.042) and EAT (P for interaction=0.022) on the CR-3yr. In contrast, there were no significant sex differences in the CR-3yr risk factors in patients with paroxysmal AF. Conclusions: A large EAT volume was associated with a higher CR-3yr, especially in males after PeAF ablation. The absence of diabetes in women was independently associated with AF recurrence after PeAF ablation.

Bibliographic Details

Dongseon Kang; Daehoon Kim; Je-Wook Park; Hee Tae Yu; Tae-Hoon kim; Boyoung Joung; Moon-Hyoung Lee; Hui-Nam Pak

Elsevier BV

Atrial fibrillation; Catheter ablation; Women

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