Paroxysmal Atrial Fibrillation in Females: Understanding gender differences

Odozynski, Gabriel; Forno, Alexander Romeno Janner Dal; Lewandowski, Andrei; Nascimento, Hélcio Garcia; d’Ávila, André

doi:10.5935/abc.20180069

Cited by 2 publications

(3 citation statements)

References 25 publications

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“…The database searches produced a total of 5716 citations, of which 19 studies met the inclusion criteria and were included in the analysis 5,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] (Figure 1). These studies included a total of 244 353 patients undergoing AFCA, of whom 33% were women (163 216 men and 81 137 women).…”

Section: Resultsmentioning

confidence: 99%

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Sex‐based differences in procedural complications associated with atrial fibrillation catheter ablation: A systematic review and meta‐analysis

Campbell

Larson

Westerman

et al. 2020

Cardiovasc electrophysiol

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Background: Women undergoing atrial fibrillation catheter ablation (AFCA) have higher rates of vascular complications and major bleeding. However, most studies have been underpowered to detect differences in rarer complications such as stroke/transient ischemic attack (TIA) and procedural mortality. Methods: We performed a systematic review of databases (PubMed, World of Science, and Embase) to identify studies published since 2010 reporting AFCA complications by sex. Six complications of interest were (1) vascular/groin complications; (2) pericardial effusion/tamponade; (3) stroke/TIA; (4) permanent phrenic nerve injury; (5) major bleeding; and (6) procedural mortality. For meta-analysis, random effects models were used when heterogeneity between studies was ≥50% (vascular complications and major bleeding) and fixed effects models for other endpoints. Results: Of 5716 citations, 19 studies met inclusion criteria, comprising 244,353 patients undergoing AFCA, of whom 33% were women. Women were older (65.3 ± 11.2 vs. 60.4 ± 13.2 years), more likely hypertensive (60.6% vs. 55.5%) and diabetic (18.3% vs. 16.5%), and had higher CHA 2 DS 2-VASc scores (3.0 ± 1.8 vs. 1.4 ± 1.4) (p < .0001 for all comparisons). The rates of all six complications were significantly higher in women. However, despite statistically significant differences, the overall incidences of major complications were very low in both sexes: stroke/ TIA (women 0.51% vs. men 0.39%) and procedural mortality (women 0.25% vs. men 0.19%). Conclusion: Women experience significantly higher rates of AFCA complications. However, the incidence of major procedural complications is very low in both sexes. The higher rate of complications in women may be partially attributable to older age and a higher prevalence of comorbidities at the time of ablation. More detailed studies are needed to better define the mechanisms of increased risk in women and to identify strategies for closing the sex gap.

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Section: Resultsmentioning

confidence: 99%

“…Mortality was reported in 12 studies, of which three 17,21,27 did not report any deaths in either sex. The overall mortality rate associated with AFCA was very low at 0.21% (402 deaths out of 195,869 patients undergoing AFCA in 12 studies).…”

Section: Procedural Mortalitymentioning

confidence: 99%

Sex‐based differences in procedural complications associated with atrial fibrillation catheter ablation: A systematic review and meta‐analysis

Campbell

Larson

Westerman

et al. 2020

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…282 • Em uma série de casos de um único centro, 225 pacientes com FA paroxística [64 mulheres (29%) e 161 homens (61%)] foram submetidos a ablação por cateter, havendo recorrência de 21% entre as mulheres e de 20% entre os homens (p = 0,89) em seguimento de 1 ano. 283 Pesquisa Futura…”

Section: Doenças Associadas E Comorbidadesunclassified