Key result
Female sex shows no difference in AF recurrence versus males after HPSD PVI in obese patients.
Why the study?
As treatment methods for AF evolve, optimizing personalized therapy based on patient characteristics such as sex is crucial, motivating an investigation of sex differences in high-power short-duration PVI among overweight and obese patients.
Does female sex affect the efficacy and safety of high-power short-duration pulmonary vein isolation in overweight and obese patients with atrial fibrillation?
Cohort (n=189)
No
Does female sex affect the efficacy and safety of high-power short-duration pulmonary vein isolation in overweight and obese patients with atrial fibrillation?
Effect estimate: HR 0.7379 (95% CI 0.3693-1.475)
Absolute Event Rate: 18.84% vs 20%
p-value: p=0.3895
In overweight and obese patients undergoing high-power short-duration pulmonary vein isolation, safety and efficacy outcomes are comparable between sexes despite women presenting at an older age with more advanced atrial substrate.
Comparable recurrence risk by sex after HPSD PVI in overweight AF patients; supports efficacy equivalence but leaves open randomized confirmation.
Atrial fibrillation (AF) is the most common heart rhythm disorder worldwide. As treatment methods evolve, optimizing personalized therapy based on patient characteristics, such as sex, becomes crucial. This study investigates sex differences in high-power short-duration (HPSD) pulmonary vein isolation (PVI) in overweight and obese patients. We analyzed data from 189 overweight and obese patients who underwent HPSD PVI for AF, comparing demographic information, procedural details, outcomes, and complications between male and female patients. Our analysis revealed fewer women underwent PVI compared to men, with women typically older and showing more pronounced changes in the left atrial substrate. Despite these differences, the safety and efficacy of PVI were comparable between sexes, including in the BMI ≥ 30 kg/m2 subgroup and after age adjustment. The findings emphasize the need for early AF screening in women to prevent treatment delays and show that considering sex-specific differences in fat distribution can improve procedural outcomes. These insights support the need for tailored management strategies for AF in overweight and obese populations, addressing sex-specific risks and anatomical variations.
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Weyand et al. (2024) conducted a cohort in Atrial fibrillation (n=189). Female sex (in high-power short-duration pulmonary vein isolation) vs. Male sex was evaluated on Atrial fibrillation recurrence after 90-day blanking period (HR 0.7379, 95% CI 0.3693-1.475, p=0.3895). Female sex did not significantly affect the risk of atrial fibrillation recurrence compared to male sex in overweight and obese patients undergoing high-power short-duration pulmonary vein isolation (HR 0.74).
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