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. 2022 Dec 16;22(1):549.
doi: 10.1186/s12872-022-03002-z.

Sex differences involved in persistent atrial fibrillation recurrence after radiofrequency ablation

Haiwei Li  1 , Zefeng Wang  2 , Zichao Cheng  1 , Yingming Zhu  3 , Zhongyu Yuan  1 , Jianwei Gao  1   4 , Xiaoping Zhang  5   6   7 , Yongquan Wu  8
Affiliations

Sex differences involved in persistent atrial fibrillation recurrence after radiofrequency ablation

Haiwei Li et al. BMC Cardiovasc Disord. .

Abstract

Background: In recent years, the difference in outcomes of radiofrequency catheter ablation (RFCA) in persistent atrial fibrillation patients has risen. In particular, biological sex seems involved in a different response to the AF ablation procedure. In our study, we analyzed the AF recurrences after RFCA assessing the other association between male/female patients with the outcomes.

Methods: We enrolled 106 patients (74.5% men) with persistent atrial fibrillation with scheduled follow-up. The baseline clinical characteristics and AF recurrence after RFCA were compared between men and women. Cox regression analyses were performed to determine the risk predictors of AF recurrence.

Results: The proportion of RFCA in women was lower than that in men. Men with persistent AF were younger than women (58.6 ± 10.4 years vs. 65.1 ± 8.7 years, respectively; p = 0.003). The left atrium (LA) diameter was higher in males (43.7 ± 4.6 mm vs. 41.3 ± 5.5 mm; p = 0.028), and the level of left heart ejection fraction (LVEF) was higher in females (59.4 ± 6.9% vs. 64.1 ± 5.5%; p = 0.001). Sex differences in AF recurrence after RFCA were significant during the median 24.4-month (interquartile range: 15.2-30.6 months) follow-up period, and the recurrence rate of AF in women was significantly higher than that in men (p = 0.005). Univariable Cox regression analysis showed that female sex was a risk factor for persistent AF recurrence after RFCA [HR: 2.099 (1.087-4.053)]. Univariate Cox regression analysis revealed that non-PV ablation not associated with AF recurrence [HR: 1.003 (0.516-1.947)].

Conclusion: In a monocentric cohort of persistent AF patients, the female biological sex was associated with a higher risk of AF recurrence after RFCA.

Keywords: Persistent atrial fibrillation; Radiofrequency ablation; Recurrence; Sex differences.

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Conflict of interest statement

All the authors have no conflicts of interest and had access to the data and wrote the manuscript.

Figures

Fig. 1
Fig. 1
Flow diagram showing population selection and study design
Fig. 2
Fig. 2
Kaplan–Meier survival curves for Freedom from AF/AT recurrence stratified by gender
See this image and copyright information in PMC

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