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November 11, 2025European Heart Journal

Left-atrial low-voltage areas and sex: mechanisms and insights into sex-related differences in atrial fibrillation susceptibility

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Why the study?

Are there sex-related differences in left-atrial low-voltage areas and atrial remodeling that explain atrial fibrillation susceptibility?

Comparison

Women vs men

Key result

Women had greater areas of left-atrial low-voltage, smaller atria, and smaller cardiomyocytes compared to men, despite no differences in the degree of atrial remodeling.

Authors

SNStanley Nattel

Discussion

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Member takes

Overview

May warrant sex-specific voltage thresholds during AF ablation; leaves open whether these substrate differences alter outcomes or guide therapy.

Structured PICO

Are there sex-related differences in left-atrial low-voltage areas and atrial remodeling that explain atrial fibrillation susceptibility?

P
Population
Men and women (implied context of atrial fibrillation susceptibility)
O
Outcome
Left-atrial low-voltage areas, atrial size, cardiomyocyte size, and degree of atrial remodelingsurrogate

This commentary highlights that women exhibit greater left-atrial low-voltage areas and smaller atria and cardiomyocytes than men, providing mechanistic insights into sex differences in atrial fibrillation.

Cite This Study

Stanley Nattel (2025) studied this question. Women had greater areas of left-atrial low-voltage, smaller atria, and smaller cardiomyocytes compared to men, despite no differences in the degree of atrial remodeling.

synapsesocial.com/papers/6aa75661470ee4088a46d4a9https://doi.org/10.1093/eurheartj/ehaf767
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