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Effectiveness and safety of atrial fibrillation ablation in females
Author(s) -
Li Jingye,
Sang Caihua,
Du Xin,
He Liu,
Lu Shangxin,
Jiang Chao,
Xia Shijun,
Chang Sanshuai,
Zuo Song,
Guo Xueyuan,
Li Songnan,
Tang Ribo,
Liu Nian,
Bai Rong,
Jiang Chenxi,
Yu Ronghui,
Long Deyong,
Macle Laurent,
Dong Jianzeng,
Ma Changsheng
Publication year - 2020
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.13921
Subject(s) - medicine , atrial fibrillation , confounding , female sex , ablation , incidence (geometry) , cardiology , risk factor , hyperlipidemia , catheter ablation , endocrinology , diabetes mellitus , physics , optics
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.