title: Gender-related differences in catheter ablation of atrial fibrillation.
abstract: OBJECTIVE
  Women have an increased risk for atrial fibrillation (AF)-related complications and there is evidence towards a reduced efficacy of the rhythm control strategy than men. A catheter-based strategy is therefore widely attractive, but the impact of gender on catheter ablation (CA) of AF remains undefined.
  
  
  RESULTS
  We included 221 consecutive patients (150 men) who underwent CA of drug-refractory AF. Gender differences in clinical presentation and outcomes were compared. Women were older (P = 0.002), had a longer history of AF (P = 0.04), and were more likely to have hypertension (P = 0.04). Moreover, a concomitant valvular heart disease tended to be more common in women (32.4 vs. 23.3%; P = 0.28) and left atrium dimensions were significantly larger (P = 0.003). However, acute success rate and complications rate were similar between genders. After 22.5 +/- 11.8 months of follow-up, the overall freedom from arrhythmia recurrences was similar (83.1 vs. 82.7% in men), and a similar improvement in SF-36 quality of life scores was achieved in both groups.
  
  
  CONCLUSIONS
  Women are referred for AF ablation later with a more complex clinical pre-operative presentation. Despite this higher risk profile in women, no differences were detected in clinical outcomes. Our findings indicate that CA of AF appears to be safe and effective in women as in men.
authors.affiliation: Arrhythmia and Electrophysiology Center, St Ambrogio Clinical Institute, Via Luigi Faravelli, 16-20149 Milan, Italy. forleo@tiscali.it
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Forleo
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
authors.forename: Lucia
authors.initials: L
authors.lastname: De Luca
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.forename: Michela
authors.initials: M
authors.lastname: Casella
authors.forename: Valerio
authors.initials: V
authors.lastname: De Sanctis
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Clementi
authors.forename: Rafael Lopes
authors.initials: RL
authors.lastname: Fagundes
authors.forename: Roberto
authors.initials: R
authors.lastname: Leo
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
authors.forename: Massimo
authors.initials: M
authors.lastname: Mantica
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012008:Recurrence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D016896:Treatment Outcome