Abstract
Background Sex-specific outcomes following AF ablation (CA) have reported conflicting findings. We examined sex-specific outcomes in patients with persistent AF(PsAF) undergoing CA from the CAPLA randomised trial. Methods 338 patients with PsAF were randomised to pulmonary vein isolation (PVI) or PVI with posterior wall isolation (PWI). The primary outcome was arrhythmia recurrence at 12 months. Clinical and electroanatomical characteristics, arrhythmia recurrence and quality of life (QOL) were compared in women and men. Results Women (79/338, 23.4%) were older (median age 70.4 (IQR 64.8–74.6) vs 64.0 (IQR 56.7–69.7) years, p<0.001) with more advanced LA electroanatomical remodeling. At 12 months, arrhythmia-free survival was lower among women (44.3% vs 56.8% in men, HR 1.44, 95% CI 1.02–2.04, LogRank p=0.036). PWI did not improve arrhythmia-free survival (p=0.711). Median AF burden was 0% in both groups (women: IQR 0.0–2.2% vs men: IQR 0.0–2.8%, p=0.804). Healthcare utilisation was comparable in women (36.7%) and men (30.1%, p=0.241), however women were more likely to undergo a repeat procedure (17.7% vs 6.9%, p=0.007). Women reported more severe anxiety (HADS anxiety score 7.5±4.9 vs 6.3±4.3 in men, p=0.035) and AF-related symptoms (AFEQT 46.7±20.7 vs 55.9±23.0 in men, p=0.002) at baseline, however experienced greater symptoms attenuation and enhanced QOL at 12 months (ΔAFEQT +45.9±23.1 vs +39.2±24.8, p=0.048), irrespective of arrhythmia recurrence. Conclusion Women undergoing CA for PsAF report more severe symptoms and poorer QOL at baseline. Despite higher arrhythmia recurrence and repeat procedures among women, AF burden was comparably low, resulting in significant improvements in quality of life and psychological wellbeing following CA in both sexes.
Original language | English |
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Pages (from-to) | S430 |
Journal | Heart Lung and Circulation |
Volume | 33 |
DOIs | |
Publication status | Published or Issued - Aug 2024 |
Externally published | Yes |
Event | 72nd Annual Scientific Meeting of the Cardiac Society of Australia and New Zealand - Perth, Australia Duration: 1 Aug 2024 → 4 Aug 2024 |
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine