Key result
Female patients undergoing catheter ablation for atrial fibrillation had a significantly higher rate of major vascular complications compared to males (3.5% vs 1.8%, p<0.0001).
Why the study?
Catheter ablation for AF carries a considerable risk of complications, with major vascular complications being the most frequent, prompting investigation into gender differences in these events.
Does female gender increase the risk of major vascular complications in patients undergoing catheter ablation for atrial fibrillation?
Observational (n=4,734)
No
Does female gender increase the risk of major vascular complications in patients undergoing catheter ablation for atrial fibrillation?
Absolute Event Rate: 3.5% vs 1.8%
p-value: p=<0.0001
Females have a higher risk of major vascular complications following catheter ablation for atrial fibrillation compared to males, a difference driven primarily by lower body size.
AIMS: Catheter ablation (CA) for atrial fibrillation (AF) has a considerable risk of procedural complications. Major vascular complications (MVCs) appear to be the most frequent. This study investigated gender differences in MVCs in patients undergoing CA for AF in a high-volume tertiary center. METHODS: at the time of the procedure. Radiofrequency point-by-point ablation was employed in 96.3% of procedures with the use of three-dimensional navigation systems and facilitated by intracardiac echocardiography. Pulmonary vein isolation was mandatory; cavotricuspid isthmus and left atrial substrate ablation were performed in 22% and 38% procedures, respectively. MVCs were defined as those that resulted in permanent injury, required intervention, or prolonged hospitalization. Their rates and risk factors were compared between genders. RESULTS: A total of 112 (2.4%) MVCs were detected: 54/1512 (3.5%) in females and 58/3222 (1.8%) in males (p < .0001). On multivariate analysis, lower body height was the only risk factor for MVCs in females (p = .0005). On the contrary, advanced age was associated with MVCs in males (p = .006). CONCLUSION: Females have a higher risk of MVCs following CA for AF compared to males. This difference is driven by lower body size in females. Low body height in females and advanced age in males are independent predictors of MVCs. Ultrasound-guided venipuncture lowered the MVC rate in males.
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Plášek et al. (2021) conducted an observational in Atrial fibrillation (n=4,734). Female gender vs. Male gender was evaluated on Major vascular complications (resulting in permanent injury, required intervention, or prolonged hospitalization) (p=<0.0001). Female patients undergoing catheter ablation for atrial fibrillation had a significantly higher rate of major vascular complications compared to males (3.5% vs 1.8%, p<0.0001).
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