Outcomes and complications of catheter ablation for atrial fibrillation in females

Heart Rhythm. 2010;7(2):167-72. doi: 10.1016/j.hrthm.2009.10.025. Epub 2009 Oct 23.

Abstract

Background: Most atrial fibrillation (AF) ablation studies have consisted predominantly of males; accordingly, there is a paucity of information on the safety and efficacy of catheter ablation in a large cohort of female AF patients.

Objective: The purpose of this study was to evaluate catheter ablation for AF in female patients.

Methods: From January 2005 to May 2008, 3265 females underwent pulmonary vein antrum isolation. Success rates, patient profiles, and complications were collected.

Results: Approximately 16% of our population was female (P <.001). Females were older (59 +/- 13 vs. 56 +/- 19 years; P <.01) and had a lower prevalence of paroxysmal atrial fibrillation (PAF; 46% vs. 55%; P <.001). Females failed more antiarrhythmics (4 +/- 1 vs. 2 +/- 3; P = .04) and were referred later for catheter ablation (6.51 +/- 7 vs. 4.85 +/- 6.5 years; P = .02) than males. More females failed ablation (31.5% vs. 22.5%; P = .001) and had nonantral sites of firing than males (P <.001). Female patients had 11 (2.1%) hematomas versus 27 (0.9%) in males.

Conclusions: Five times as many males underwent catheter ablation than females. Females failed more ablations possibly because of a higher prevalence of nonantral firing, non-PAF, and longer history of AF. Females had more bleeding complications than males.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Anticoagulants / administration & dosage
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / methods*
  • Chi-Square Distribution
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Proportional Hazards Models
  • Pulmonary Veins / physiopathology
  • Pulmonary Veins / surgery*
  • Registries
  • Retrospective Studies
  • Sex Factors
  • Treatment Outcome

Substances

  • Anticoagulants