Are there gender-based differences in the atrial and pulmonary vein electrophysiologic substrate among patients with or without atrial fibrillation?
Despite known clinical gender differences in atrial fibrillation, there are no systematic gender-based differences in the underlying atrial or pulmonary vein electrophysiologic substrate.
BACKGROUND: Gender-based differences in the clinical nature of cardiac arrhythmias such as atrial fibrillation (AF) are well established. OBJECTIVE: The purpose of this study was to identify any such gender-based differences in the underlying pulmonary vein and atrial substrate. METHODS AND RESULTS: Thirty-eight patients with no history of AF undergoing catheter ablation for supraventricular tachycardia (SVT) and 55 with paroxysmal or persistent AF undergoing catheter ablation of AF underwent detailed electroanatomic mapping of the pulmonary veins and atria. Refractory periods in multiple locations, sinus node function, endocardial bipolar voltage, pulmonary vein and atrial conduction, and bipolar electrogram complexity were analyzed. There were no significant between-gender differences in age or other clinical variables known to impact on the atrial or pulmonary vein substrate. In neither the AF nor the non-AF cohorts were there any significant differences in atrial or pulmonary vein refractoriness, sinus node function, any measure of PV electrophysiology, or any measure of atrial electrophysiology. CONCLUSION: No systematic between-gender differences were observed in the PV or atrial substrate either in those with or without a history of AF, with a similar prevalence of the cardiovascular comorbidities frequently associated with atrial remodeling and AF seen in both male and female groups.
Walters et al. (Thu,) studied this question.