Outcomes and complications of catheter ablation for atrial fibrillation in females.
BACKGROUND
Most atrial fibrillation (AF) ablation studies have consisted predominantly of males; accordingly, there is a paucity of information on the safety and efficacy of catheter ablation in a large cohort of female AF patients.


OBJECTIVE
The purpose of this study was to evaluate catheter ablation for AF in female patients.


METHODS
From January 2005 to May 2008, 3265 females underwent pulmonary vein antrum isolation. Success rates, patient profiles, and complications were collected.


RESULTS
Approximately 16% of our population was female (P <.001). Females were older (59 +/- 13 vs. 56 +/- 19 years; P <.01) and had a lower prevalence of paroxysmal atrial fibrillation (PAF; 46% vs. 55%; P <.001). Females failed more antiarrhythmics (4 +/- 1 vs. 2 +/- 3; P = .04) and were referred later for catheter ablation (6.51 +/- 7 vs. 4.85 +/- 6.5 years; P = .02) than males. More females failed ablation (31.5% vs. 22.5%; P = .001) and had nonantral sites of firing than males (P <.001). Female patients had 11 (2.1%) hematomas versus 27 (0.9%) in males.


CONCLUSIONS
Five times as many males underwent catheter ablation than females. Females failed more ablations possibly because of a higher prevalence of nonantral firing, non-PAF, and longer history of AF. Females had more bleeding complications than males.
Patel
Dimpi
D
St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, TX, USA.
Mohanty
Prasant
P
Di Biase
Luigi
L
Sanchez
Javier E
JE
Shaheen
Mazen H
MH
Burkhardt
J David
JD
Bassouni
Mohammed
M
Cummings
Jennifer
J
Wang
Yan
Y
Lewis
William R
WR
Diaz
Alberto
A
Horton
Rodney P
RP
Beheiry
Salwa
S
Hongo
Richard
R
Gallinghouse
G Joseph
GJ
Zagrodzky
Jason D
JD
Bailey
Shane M
SM
Al-Ahmad
Amin
A
Wang
Paul
P
Schweikert
Robert A
RA
Natale
Andrea
A
D000704:Analysis of Variance; D000925:Anticoagulants / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome
D000925:Anticoagulants