Key result
Female sex is linked to ~24% higher 3-year AF recurrence after initial ablation versus males.
Why the study?
The impact of sex differences on the clinical outcomes of radiofrequency catheter ablation of atrial fibrillation remains controversial.
Does female sex increase the risk of AF recurrence and adverse clinical outcomes in patients undergoing initial radiofrequency catheter ablation for atrial fibrillation?
Population
5010 consecutive patients undergoing initial RFCA of AF at 26 centres
Comparison
Female vs male patients
Design
Large-scale prospective multicentre observational study
Follow-up
Median 2.9 years
Authors
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May support closer post-ablation monitoring in women; leaves open whether sex-specific strategies improve outcomes in randomized trials.
Observational (n=5,010)
Yes
Does female sex increase the risk of AF recurrence and adverse clinical outcomes in patients undergoing initial radiofrequency catheter ablation for atrial fibrillation?
Hazard Ratio: 1.24 (95% CI 1.12–1.38)
Absolute Event Rate: 43.3% vs 39%
p-value: p=<0.0001
Female patients undergoing initial RFCA for AF have a significantly higher risk of long-term AF recurrence, de novo pacemaker implantation, heart failure hospitalization, and major bleeding compared to males.
Tanaka et al. (2020) conducted an observational in Atrial fibrillation (n=5,010). Female sex vs. Male sex was evaluated on 3-year cumulative incidence of atrial fibrillation recurrences after single procedures (HR 1.24, 95% CI 1.12-1.38, p=<0.0001). Female sex was associated with a higher 3-year incidence of atrial fibrillation recurrence after initial ablation compared to males (43.3% vs 39.0%; HR 1.24; 95% CI 1.12-1.38; P<0.0001).
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