Ab-452665-1 gender based differences in safety and outcomes of catheter ablation procedure for atrial fibrillation

Studies have identified significant sex-based differences and disparities in the clinical presentation and treatment of atrial fibrillation (AF). Women are less likely to be referred for catheter ablation, are older at the time of ablation, and are more likely to have recurrence after ablation. It is important to note, however, that in most studies investigating AF ablation outcomes, the female cohorts were relatively small. The impact of gender on the outcome and safety of ablation procedures is still unclear due to the paucity of evidence on the topic. To investigate gender differences in outcomes and complications after AF catheter ablation, with a significant size female cohort in the study population In this retrospective observational study, patients undergoing first catheter ablation for AF from January 1, 2014, to March 31, 2021, were included. We investigated clinical characteristics, duration and progression of AF, number of electrophysiologist appointments (EP) from diagnosis to ablation, procedural data, and procedure complications. The primary endpoint of this study was arrhythmia recurrence, and the secondary endpoints were procedural complications and redo ablation. Total 1346 patients underwent first catheter ablation for AF during this period, including 896 (66.5%) male and 450 (33.4%) female patients (Table 1). Female patients were older at the time of ablation (66.2y vs 62.4y; p<0.001). Women had higher CHA2DS2-VASc scores (3 vs 2; p<0.001) than men, expectedly, as the female sex warrants an additional point. 25.3% female patients had persistent AF (PersAF) at the time of diagnosis vs 35.3% male patients (p<0.001). At the time of ablation, 31.8% female patients had PersAF as compared to 43.1% male patients (p<0.001), indicating progression of paroxysmal AF (PAF) to PersAF in both genders. Female group presented for more EP appointments and tried more antiarrhythmic drugs (AADs) than the male group before ablation (1.13 vs 0.98; p=0.002). Male and female patients had no statistically significant difference in (a) arrhythmia recurrence at 1-y post ablation (27.7% vs 30%; p=0.38) or (b) procedural complication rate (1.8% vs 3.1%; p=0.56). Female patients were older and had higher CHA2DS2-VASc scores compared to males at the time of AF ablation. Female patients tried more AADs and visited with electrophysiologists more leading up to ablation. 1-y arrhythmia recurrence rates and procedural complications were similar in both genders.