When undergoing catheter ablation for atrial fibrillation (AFib), women, compared with men, are more likely to be older, have more comorbidities and have a lower AFib-related quality of life, and they experience a greater risk of in-hospital adverse events, according to a recent study in Heart.

In what they say is the largest registry-based study to date, Reed Mszar, MPH, et al., examined sex-based differences in baseline and procedural characteristics, adverse events and quality of life in adults undergoing AFib catheter ablation. The researchers examined data from 58,960 patient records (34.6% women) collected between January 2016 and September 2020 in ACC’s AFib Ablation Registry, and used logistic regression to assess the association between patient sex and in-hospital adverse events for AFib ablation procedures.

Results showed that at the time of the ablation, women compared with men were older (68 vs. 64 years), had more comorbidities, and had a lower AF Effect on QualiTy-of-life Questionnaire (AFEQT) score (51.8 vs. 62.2).

Furthermore, women had a higher risk of hospitalization for more than one day (adjusted odds ratio [aOR], 1.41), major adverse events (aOR, 1.60) and any adverse event (aOR ,1.57), compared with men. Notably, for specific adverse events, women had a higher risk of bradycardia requiring a pacemaker, phrenic nerve damage, pericardial effusion, as well as bleeding and vascular injury. No differences were found between women and men for death or acute pulmonary vein isolation.

In light of the sex-related disparities in AFib identified in their study, Mszar et al., write, “Our findings suggest that consideration should be given to including a recommendation [in international guidelines] for tailoring intraprocedural and periprocedural care to mitigate the higher risk profile of the procedure for women.”

Clinical Topics: Arrhythmias and Clinical EP, Pericardial Disease, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Hospitals, Pacemaker, Artificial, Surveys and Questionnaires, Hospitalization, Registries, Catheter Ablation, Vascular System Injuries, Phrenic Nerve, Pericardial Effusion, Odds Ratio, Bradycardia, Logistic Models, Pulmonary Veins, Quality of Life, Atrial Fibrillation, AFib Ablation Registry, National Cardiovascular Data Registries

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