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December 16, 2022BMC Cardiovascular DisordersOpen Access

Female sex was associated with a significantly higher risk of persistent atrial fibrillation recurrence after radiofrequency catheter ablation compared to male sex (HR 2.099).

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Why the study?

Biological sex appears involved in differing responses to AF ablation, prompting analysis of sex-based differences in persistent atrial fibrillation recurrence after radiofrequency catheter ablation.

Does female sex increase the risk of atrial fibrillation recurrence after radiofrequency catheter ablation in patients with persistent atrial fibrillation?

Population

106 patients with persistent atrial fibrillation

Comparison

Men vs women undergoing RFCA

Design

Monocentric cohort study

Follow-up

Median 24.4-month

Key result

Female sex was associated with a significantly higher risk of persistent atrial fibrillation recurrence after radiofrequency catheter ablation compared to male sex (HR 2.099).

Authors

HLHaiwei LiZWZefeng WangZCZichao Cheng

Discussion

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Member takes

Overview

In patients with persistent atrial fibrillation undergoing radiofrequency catheter ablation, female sex is associated with a significantly higher risk of arrhythmia recurrence compared to male sex.

Study Design

Type

Cohort (n=106)

Multicenter

No

Structured PICO

Does female sex increase the risk of atrial fibrillation recurrence after radiofrequency catheter ablation in patients with persistent atrial fibrillation?

P
Population
106 adults with persistent atrial fibrillation undergoing their first radiofrequency catheter ablation, free of other cardiovascular diseases, followed for a median of 24.4 months.
E
Exposure
Radiofrequency catheter ablation (circumferential pulmonary vein isolation with selective additional atrial ablation) in female patients
C
Comparator
Radiofrequency catheter ablation in male patients
O
Outcome
Atrial fibrillation recurrence defined as any documented atrial tachyarrhythmia (atrial fibrillation, atrial flutter, or atrial tachycardia) episode lasting for at least 30 s after RFCA, excluding 3-month blanking periodhard clinical

Main Result

Hazard Ratio: 2.099 (95% CI 1.087–4.053)

Absolute Event Rate: 55.2% vs 26%

p-value: p=0.027

In patients with persistent atrial fibrillation undergoing radiofrequency catheter ablation, female sex is associated with a significantly higher risk of arrhythmia recurrence compared to male sex.

Limitations

  • Single-center study, which may be prone to selection bias or information bias.
  • Small sample size, which may have been underpowered to detect some real differences between groups.
  • Use of 24-h Holter monitoring may lead to an underestimation of recurrence rates compared with implanted loop recorders.
  • Results may have been influenced by operator experience and varying techniques, limiting generalizability.
  • Small sample size, which may have been underpowered to detect some real differences
  • 24-h Holter monitoring may lead to an underestimation of recurrence rates compared with implanted loop recorders
  • Single-center study with potential selection bias
  • Results may have been influenced by inclusion/exclusion criteria, operator experience, and varying techniques

Cite This Study

Li et al. (2022) conducted a cohort in Persistent atrial fibrillation (n=106). Female sex vs. Male sex was evaluated on Persistent atrial fibrillation recurrence (HR 2.099, 95% CI 1.087-4.053, p=0.027). Female sex was associated with a significantly higher risk of persistent atrial fibrillation recurrence after radiofrequency catheter ablation compared to male sex (HR 2.099).

synapsesocial.com/papers/6a98cb79bed7bbff3f75b190https://doi.org/10.1186/s12872-022-03002-z
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Sex differences in atrial fibrillation ablation outcomes: insights from a large-scale multicentre registry2020 · 52 citations
  2. 2Sex Difference in Atrial Fibrillation Recurrence After Catheter Ablation2023
  3. 3Gender-related Difference in Clinical Outcome of the Patient with Atrial Fibrillation after Radiofrequency Catheter Ablation2018 · 14 citations
  4. 4Sex-Related Differences in Atrial Remodeling in Patients With Atrial Fibrillation: Relationship to Ablation Outcomes2021 · 109 citations
  5. 5Sex differences after atrial fibrillation ablation: a patient level meta-analysis2026