Gender differences in patients referred for atrial fibrillation management to a tertiary center.
BACKGROUND
Atrial fibrillation (AF) ablation is less frequently performed in women than in men. Although the prevalence of AF is slightly higher in men, this does not fully account for the lower number of AF ablations performed in women. This study sought to examine the effect of gender on referral for AF and subsequent AF management.


METHODS
Consecutive patients referred to our tertiary arrhythmia outpatient clinic for AF management were retrospectively analyzed.


RESULTS
Of 264 patients referred, only 27% were women. Women were older than men (63 +/- 9 vs 58 +/- 11 years, P = 0.002), more often had paroxysmal AF (78% vs 63% in men, P = 0.022), and women more frequently complained about palpitations (71% vs 49%, P = 0.002). In addition, they had more often experienced amiodarone side effects than men (56% vs 36%, P = 0.046). In this referred population, there was no difference in the proportion of women and men undergoing AF ablation immediately following the initial evaluation (21% vs 25%, P = ns), at any time during the follow-up (38% vs 44%, P = ns), and there was no difference in the proportion of patients undergoing atrioventricular node ablation in both sexes (6% of women vs 3% of men, P = ns).


CONCLUSIONS
There is an important difference in the proportion of men and women referred for management of AF in a specialized outpatient arrhythmia clinic, with women being referred three times less often than men. However, there is no gender-related difference in the subsequent treatment decisions. These findings emphasize the importance of focusing on management of symptomatic AF in women.
Department of Cardiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland. laurent.roten@insel.ch
Laurent
L
Roten
Stefano F
SF
Rimoldi
Nicola
N
Schwick
Takao
T
Sakata
Chris
C
Heimgartner
Juerg
J
Fuhrer
Etienne
E
Delacrétaz
Hildegard
H
Tanner
D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000517:prevention & control*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007221:Industry / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D017678:Sex Distribution; D013557:Switzerland / Q000453:epidemiology