Sex differences in catheter ablation of atrial fibrillation: results from AXAFA-AFNET 5
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Sex differences in catheter ablation of atrial fibrillation: results from AXAFA-AFNET 5. / Kloosterman, Mariëlle; Chua, Winnie; Fabritz, Larissa; Al-Khalidi, Hussein R; Schotten, Ulrich; Nielsen, Jens C; Piccini, Jonathan P; Di Biase, Luigi; Häusler, Karl Georg; Todd, Derick; Mont, Lluis; Van Gelder, Isabelle C; Kirchhof, Paulus; AXAFA-AFNET 5 investigators.
in: EUROPACE, Jahrgang 22, Nr. 7, 01.07.2020, S. 1026-1035.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Sex differences in catheter ablation of atrial fibrillation: results from AXAFA-AFNET 5
AU - Kloosterman, Mariëlle
AU - Chua, Winnie
AU - Fabritz, Larissa
AU - Al-Khalidi, Hussein R
AU - Schotten, Ulrich
AU - Nielsen, Jens C
AU - Piccini, Jonathan P
AU - Di Biase, Luigi
AU - Häusler, Karl Georg
AU - Todd, Derick
AU - Mont, Lluis
AU - Van Gelder, Isabelle C
AU - Kirchhof, Paulus
AU - AXAFA-AFNET 5 investigators
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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] 3 months after ablation. Women were older (66 vs. 63 years, 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 (2.1 ± 2.3 vs. 1.6 ± 1.3 days, 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.
AB - 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] 3 months after ablation. Women were older (66 vs. 63 years, 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 (2.1 ± 2.3 vs. 1.6 ± 1.3 days, 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.
KW - Atrial Fibrillation/diagnosis
KW - Catheter Ablation/adverse effects
KW - Female
KW - Humans
KW - Male
KW - Quality of Life
KW - Sex Characteristics
KW - Stroke/epidemiology
KW - Treatment Outcome
U2 - 10.1093/europace/euaa015
DO - 10.1093/europace/euaa015
M3 - SCORING: Journal article
C2 - 32142113
VL - 22
SP - 1026
EP - 1035
JO - EUROPACE
JF - EUROPACE
SN - 1099-5129
IS - 7
ER -