Sex-based differences and risk of recurrence in patients with atrial fibrillation undergoing pulmonary vein isolation

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Francisca Almeida Saraiva

    Autor

  • Ricardo Manuel Alves Monteiro Fontes De Carvalho

    Autor

Participantes de fora da FMUP

  • Aguiar-Neves, Ines
  • Carvalho, Augusto Sa
  • Diaz, Silvia O.
  • Silva, Mariana Ribeiro
  • Silva, Gualter Santos
  • Teixeira, Rafael
  • Fernandes, Sara Lopes
  • Cruz, Ines
  • Almeida, Joao G.
  • Fonseca, Paulo
  • Oliveira, Marco
  • Goncalves, Helena
  • Barros, Antonio S.
  • Ferreira, Nuno Dias
  • Sampaio, Francisco
  • Primo, Joao

Unidades de investigação

Abstract

Introduction: Studies suggest increased likelihood of atrial fibrillation (AF) recurrence after catheter ablation (CA) in women than in men, indicating that sex may be an independent risk factor for recurrence. Nevertheless, the influence of sex on AF recurrence and underlying mechanisms remains unclear. Methods: Retrospective, single-centre study including patients undergoing AF CA between 2017 and 2021. Late recurrence (LR) was defined as AF recurrence >= 90 days after ablation, whereas early recurrence (ER) occurred within 90 days. Results: 656 patients (32% women) were included, with a median follow-up period of 26 months. Compared to men, women undergoing CA were older, had higher body mass indexes, and had higher rates of hypertension, thyroid dysfunction, and valvular disease. Women also had increased LR risk after CA (HR 1.76, 95% CI [1.19, 2.59]). A time-split multivariable analysis at one year of follow-up showed no difference in LR risk during the first 12 months after CA (HR 1.19, 95% CI [0.73, 1.94]); however, LR risk increased in women (HR 2.90, 95% CI [1.68, 5.01]) after 12 months. In a sex-stratified analysis, coronary calcium score (CCS) >100 was associated with increased LR risk in men (HR 1.81, 95% CI [1.06, 3.08]), but not in women. Cardiac adipose tissue volume was not associated with increased LR risk. Conclusions: Fewer women underwent CA than men and LR was more frequent in women, particularly one year after the procedure. CCS was associated with increased LR risk in men.

Dados da publicação

ISSN/ISSNe:
1874-1754, 0167-5273

International Journal of Cardiology  Elsevier Ireland Ltd

Tipo:
Article
Páginas:
-
Link para outro recurso:
www.scopus.com

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Keywords

  • Atrial fibrillation; Catheter ablation; Gender differences; Computed tomography; Women

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