Log in to MyACC
Impact of Female Sex on Clinical Presentation and Ablation Outcomes
Quick Takes
- Women are more symptomatic than men when presenting for catheter ablation of paroxysmal AF.
- Women respond to catheter ablation of paroxysmal AF just as favorably as men.
Study Questions:
Are there sex-related differences in symptoms or ablation outcomes between men and women undergoing catheter ablation of paroxysmal atrial fibrillation (AF)?
Methods:
The CIRCA-DOSE (Cryoballoon vs. Irrigated Radiofrequency Catheter Ablation: Double Short vs. Standard Exposure Duration) study was a randomized clinical trial of cryoballoon ablation versus radiofrequency catheter ablation of paroxysmal AF. There were 346 patients and the follow-up duration was 12 months.
Results:
There were 231 men (mean age, 57.7 years) and 115 women (mean age, 60.9 years) in the study. Pre-ablation, women had a significantly worse mean symptom score and significantly lower quality of life score than men. The overall periprocedural complication rate did not differ significantly between the men and women. Freedom from any atrial tachyarrhythmia at 12 months did not differ significantly between men (56.3%) and women (48.7%). Post-ablation, quality of life improved to the same extent in men and women. There were no significant differences between men and women in health care utilization post-ablation.
Conclusions:
Upon presentation for paroxysmal AF ablation, women are more symptomatic and have a lower quality of life than men. The outcomes of catheter ablation are similar in the sexes, with similar efficacy and improvements in symptoms and quality of life.
Perspective:
The finding that women are in general more symptomatic than men when presenting for catheter ablation confirms the results of prior studies. The reason for this is unclear but could be related to referral bias, treatment bias, or sex-related differences in either symptom threshold or the desire to avoid an invasive procedure. Contrary to the results of some prior studies, this study demonstrates that outcomes of ablation are equally good in men and women.
Clinical Topics: Arrhythmias and Clinical EP, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias
Keywords: Arrhythmias, Cardiac, Atrial Fibrillation, Catheter Ablation, Heart Atria, Quality of Life, Tachycardia, Treatment Outcome, Women
< Back to Listings
