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Efficacy and Safety of Catheter Ablation for Long‐Standing Persistent Atrial Fibrillation in Women
Author(s) -
ZHANG XIAODONG,
TAN HONGWEI,
GU JUN,
JIANG WEIFENG,
ZHAO LIANG,
WANG YUANLONG,
LIU YUGANG,
ZHOU LI,
GU JIANING,
LIU XU
Publication year - 2013
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12212
Subject(s) - medicine , atrial fibrillation , hazard ratio , catheter ablation , proportional hazards model , confidence interval , incidence (geometry) , cardiology , ablation , prospective cohort study , physics , optics
Objectives It is uncertain whether gender affects the outcomes of catheter ablation (CA) for atrial fibrillation (AF). The objective of the study is to evaluate the efficacy and safety of CA for long‐standing persistent AF in women. Methods Between January 2010 and May 2011, 220 consecutive patients (73 females, 33.2%), with long‐standing persistent AF who underwent CA were prospectively recruited. Gender‐related differences in clinical presentation, periprocedural complications, and outcomes were compared. Results Women were less likely to have lone AF than men (27.4% vs 47.6%; P = 0.004). The incidence of rheumatic heart disease was higher in women (19.2% in women vs 1.4% in men; P < 0.001). Women had a lower initial ablation success rate than men (35.6% vs 57.1%; P = 0.003). Hematomas occurred more often in women (6.8% in women vs 0.7% in men; P = 0.027). A Cox regression analysis demonstrated total duration of AF (per month, hazard ratio [HR] 1.003, confidence interval [CI] 1.001–1.006; P = 0.006) and gender (HR 1.663, CI 1.114–2.485; P = 0.013) as the independent predictors for recurrence after the first CA. Conclusions Women and long AF duration were closely related to the recurrence of AF after the first ablation in patients with long‐standing persistent AF. Women also had a higher risk of vascular complications.