Background
Catheter ablation (CA) has become a standard treatment for patients with atrial fibrillation (AF). However, gender-related differences associated with CA of paroxysmal AF (PAF) remain unclear.
Methods
We compared 1124 consecutive patients (mean age, 61 ¡À 10 years; male, n = 864) with PAF scheduled for CA between the genders.
Results
Females were significantly older (p < 0.0001), and had a lower body-mass-index (p = 0.02), smaller left atrial dimension (LAD; p = 0.04), larger LAD indexed by the body-surface-area (LADI; p < 0.0001) and better left ventricular ejection fraction (p < 0.0001) at baseline. Ischemic heart disease (p = 0.007) was more frequent in males, whereas hypertrophic cardiomyopathy (p = 0.007) and mitral stenosis (p = 0.001) were more frequent in females. More additional procedures were performed to eliminate non-pulmonary vein foci in females than males (p < 0.05), but those locations were similar between the genders. The incidence of procedure-related complications was similar between genders (p = 0.73). Sinus rhythm was similarly maintained between females and males after the first CA (56.4 % vs. 59.3 % at 5 years, p = 0.24), but was significantly lower in females after the last CA (76.5 % vs. 81.3 % at 5 years, p = 0.007). More females did refuse multiple CA procedures (especially a second one) than males (37.8 % in females vs. 27.4 % in males, p = 0.02). The age (HR, 0.98/y, p = 0.01), duration of AF (HR, 1.04/y, p = 0.0001), number of failed anti-arrhythmic-drugs (HR, 1.10, p = 0.03) and LADI (HR, 1.89 per 10 mm/m2, p = 0.001) were significantly associated with AF-recurrence in males, but not in females.
Conclusions
Specific differences and similarities between the genders were observed in PAF patients undergoing CA.
