Significant gender-related differences in radiofrequency catheter ablation therapy
Key result
Female sex is linked to a ~28-month delay in catheter ablation referral despite similar outcomes.
- P<0.001
- n=894
Why the study?
Gender-related differences may impact radiofrequency ablation therapy, but existing data were very limited and focused almost exclusively on success and recurrence rates.
Are there gender-related differences in referral patterns, procedural characteristics, and outcomes for radiofrequency catheter ablation therapy in patients with accessory pathways or AVNRT?
Population
894 consecutive patients undergoing catheter ablation of accessory pathways or AVNRT
Comparison
Female vs male patients
Design
Observational cohort study
Authors
Discussion
Loading...
Member takes
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Evidence also suggests that women with AF have a delayed referral pattern compared with men and fail more antiarrhythmic medications before catheter ablation. Delaying the time to ablation could promote a higher AF or comorbidity burden at the time of ablation, which may have resulted in more electrical and structural remodeling.”
AMAndrea M. RussoProfessor of medicine, Cooper Medical School of Rowan University
“Women have been typically underrepresented in AF ablation studies and also appear to be underrepresented in studies reporting on real-life experience with catheter ablation of atrial fibrillation; the reasons for this are unclear. When compared with drug therapy, ablation reduced arrhythmia recurrence in women as well as in men. This adds to our understanding about the impact of ablation in women, demonstrating that women should not be discouraged from undergoing ablation based on sex.”
“Even though there was increased risk for complications in women compared with men, and the difference was statistically significant, the absolute percentage differences were still somewhat small. As the researchers wrote, women tend to be more symptomatic than their male counterparts and tend to have more complications from the arrhythmia. So, I do not believe there should be a strong deterrent to do these procedures in women, because we know that women can benefit from these procedures.”
Implication
Women experience significant delays in referral for catheter ablation compared to men despite having more symptoms, though procedural efficacy and safety remain equally high for both genders.
Key Points
- This research aims to explore potential gender-related differences in the outcomes and referral patterns for radiofrequency catheter ablation therapy.
- The study involved 894 patients undergoing catheter ablation for accessory pathways and AVNRT.
- Data was analyzed comparing referral timing, symptom severity, and treatment outcomes between male and female patients.
- Statistical comparisons were made using p-values for different metrics.
- Female patients were referred for ablation later, at an average of 185 months after symptom onset compared to 157 months for males (p < 0.001).
- Women had a higher incidence of more than one tachycardia episode per month (80.3% vs. 70.3% in men, p < 0.001).
- Both genders experienced similar success, complication, and recurrence rates post-ablation.
Study Design
Type
Observational (n=894)
Structured PICO
Are there gender-related differences in referral patterns, procedural characteristics, and outcomes for radiofrequency catheter ablation therapy in patients with accessory pathways or AVNRT?
P
Population
894 consecutive patients (53.2% female) who underwent catheter ablation for accessory pathways or atrioventricular nodal re-entrant tachycardia.
E
Exposure
Radiofrequency catheter ablation therapy in female patients
C
Comparator
Radiofrequency catheter ablation therapy in male patients
O
Outcome
Gender-related differences in referral time, antiarrhythmic drug use, symptom frequency, procedural characteristics (fluoroscopy time, radiofrequency applications, procedure duration), success, complication, and recurrence rates.
Main Result
Absolute Event Rate: 185% vs 157%
p-value: p=<0.001
Women experience significant delays in referral for catheter ablation compared to men despite having more symptoms, though procedural efficacy and safety remain equally high for both genders.
Cite This Study
Dagres et al. (2003) conducted an observational in Accessory pathways and/or atrioventricular nodal re-entrant tachycardia (AVNRT) (n=894). Female sex vs. Male sex was evaluated on Time from onset of symptoms to ablation referral (months) (p=<0.001). Female patients were referred for catheter ablation significantly later than male patients (185 vs 157 months after symptom onset, P<0.001) despite having similar procedural success and recurrence rates.