Journal
EUROPACE
Volume 22, Issue 7, Pages 1026-1035Publisher
OXFORD UNIV PRESS
DOI: 10.1093/europace/euaa015
Keywords
Sex differences; Female gender; Catheter ablation; Efficacy; Safety; Complications; Quality of life; Cognitive function
Categories
Funding
- Pfizer/BMS
- German Centre for Cardiovascular Research - German Ministry of Education and Research (DZHK)
- European Union [633196]
- European Union BigData@Heart [EU IMI 116074]
- British Heart Foundation [FS/13/43/30324, PG/17/30/32961, AA/18/2/34218]
- Leducq Foundation
Ask authors/readers for more resources
Aims Study sex-differences in efficacy and safety of atrial fibrillation (AF) ablation. Methods and results We assessed first AF ablation outcomes on continuous anticoagulation in 633 patients [209 (33%) women and 424 (67%) men] in a pre-specified subgroup analysis of the AXAFA-AFNET 5 trial. We compared the primary outcome (death, stroke or transient ischaemic attack, or major bleeding) and secondary outcomes [change in quality of life (QoL) and cognitive function] 3months after ablation. Women were older (66 vs. 63years, P<0.001), more often symptomatic, had lower QoL and a longer history of AF. No sex differences in ablation procedure were found. Women stayed in hospital longer than men (2.12.3 vs. 1.6 +/- 1.3days, P=0.004). The primary outcome occurred in 19 (9.1%) women and 26 (6.1%) men, P=0.19. Women experienced more bleeding events requiring medical attention (5.7% vs. 2.1%, P=0.03), while rates of tamponade (1.0% vs. 1.2%) or intracranial haemorrhage (0.5% vs. 0%) did not differ. Improvement in QoL after ablation was similar between the sexes [12-item Short Form Health Survey (SF-12) physical 5.1% and 5.9%, P=0.26; and SF-12 mental 3.7% and 1.6%, P=0.17]. At baseline, mild cognitive impairment according to the Montreal Cognitive Assessment (MoCA) was present in 65 (32%) women and 123 (30%) men and declined to 23% for both sexes at end of follow-up. Conclusion Women and men experience similar improvement in QoL and MoCA score after AF ablation on continuous anticoagulation. Longer hospital stay, a trend towards more nuisance bleeds, and a lower overall QoL in women were the main differences observed.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available