Sex-related outcome of atrial fibrillation ablation: Insights from the German Ablation Registry
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Sex-related outcome of atrial fibrillation ablation: Insights from the German Ablation Registry. / Zylla, Maura M; Brachmann, Johannes; Lewalter, Thorsten; Hoffmann, Ellen; Kuck, Karl-Heinz; Andresen, Dietrich; Willems, Stephan; Eckardt, Lars; Tebbenjohanns, Jürgen; Spitzer, Stefan G; Schumacher, Burghard; Hochadel, Matthias; Senges, Jochen; Katus, Hugo A; Thomas, Dierk.
in: HEART RHYTHM, Jahrgang 13, Nr. 9, 09.2016, S. 1837-44.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Sex-related outcome of atrial fibrillation ablation: Insights from the German Ablation Registry
AU - Zylla, Maura M
AU - Brachmann, Johannes
AU - Lewalter, Thorsten
AU - Hoffmann, Ellen
AU - Kuck, Karl-Heinz
AU - Andresen, Dietrich
AU - Willems, Stephan
AU - Eckardt, Lars
AU - Tebbenjohanns, Jürgen
AU - Spitzer, Stefan G
AU - Schumacher, Burghard
AU - Hochadel, Matthias
AU - Senges, Jochen
AU - Katus, Hugo A
AU - Thomas, Dierk
N1 - Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
PY - 2016/9
Y1 - 2016/9
N2 - BACKGROUND: Stratification of patients with atrial fibrillation (AF) according to mechanistic and prognostic criteria may optimize the effectiveness and safety of catheter ablation. In women, AF is associated with more severe symptoms and worse prognosis.OBJECTIVE: We sought to assess sex-related differences in catheter ablation procedures and outcome in a large cohort of patients with AF.METHODS: A total of 3652 patients (1198 women [33%]; 2454 men [67%]) included in the German Ablation Registry were analyzed. Periprocedural parameters and outcome at 12-month follow-up were compared between male and female patients.RESULTS: Women were older at the time of ablation (women: 63.6 years; men: 59.1 years; P < .0001) and exhibited a higher prevalence of paroxysmal AF (women: 72%; men: 61%; P < .0001). They were less often affected by cardiovascular disease and reduced left ventricular function. Energy application duration and overall procedure duration were shorter in women. Conversely, the rate of major inhospital complications was increased in female patients (1.9% vs 0.8%; P = .023) and mainly driven by major bleeding events. At follow-up, women experienced higher AF recurrence rates (women: 50%; men: 45%; P = .017) and more often received oral medication for rhythm and rate control. In addition, the rate of pacemaker implantation was higher in the female cohort. Women more frequently reported femoral access site complications (women: 6%; men: 3%; P < .001). Overall, male patients were more often free from AF-related symptoms and satisfied with the treatment.CONCLUSION: Catheter ablation of AF was associated with a distinct sex-related outcome and complication profile that requires consideration in clinical practice.
AB - BACKGROUND: Stratification of patients with atrial fibrillation (AF) according to mechanistic and prognostic criteria may optimize the effectiveness and safety of catheter ablation. In women, AF is associated with more severe symptoms and worse prognosis.OBJECTIVE: We sought to assess sex-related differences in catheter ablation procedures and outcome in a large cohort of patients with AF.METHODS: A total of 3652 patients (1198 women [33%]; 2454 men [67%]) included in the German Ablation Registry were analyzed. Periprocedural parameters and outcome at 12-month follow-up were compared between male and female patients.RESULTS: Women were older at the time of ablation (women: 63.6 years; men: 59.1 years; P < .0001) and exhibited a higher prevalence of paroxysmal AF (women: 72%; men: 61%; P < .0001). They were less often affected by cardiovascular disease and reduced left ventricular function. Energy application duration and overall procedure duration were shorter in women. Conversely, the rate of major inhospital complications was increased in female patients (1.9% vs 0.8%; P = .023) and mainly driven by major bleeding events. At follow-up, women experienced higher AF recurrence rates (women: 50%; men: 45%; P = .017) and more often received oral medication for rhythm and rate control. In addition, the rate of pacemaker implantation was higher in the female cohort. Women more frequently reported femoral access site complications (women: 6%; men: 3%; P < .001). Overall, male patients were more often free from AF-related symptoms and satisfied with the treatment.CONCLUSION: Catheter ablation of AF was associated with a distinct sex-related outcome and complication profile that requires consideration in clinical practice.
KW - Atrial Fibrillation/surgery
KW - Catheter Ablation/adverse effects
KW - Female
KW - Germany
KW - Humans
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Registries
KW - Risk Assessment
KW - Sex Factors
U2 - 10.1016/j.hrthm.2016.06.005
DO - 10.1016/j.hrthm.2016.06.005
M3 - SCORING: Journal article
C2 - 27289011
VL - 13
SP - 1837
EP - 1844
JO - HEART RHYTHM
JF - HEART RHYTHM
SN - 1547-5271
IS - 9
ER -