title: Temporal trends and sex differences in pulmonary vein isolation for patients with atrial fibrillation.
abstract: BACKGROUND
  Indications for pulmonary vein isolation for the treatment of atrial fibrillation (AF) have expanded over the years.
  
  
  OBJECTIVE
  We aimed to describe trends in demographic and clinical characteristics of patients undergoing ablation, with a particular focus on sex differences.
  
  
  METHODS
  Patients who underwent first AF ablation between 2003 and 2012 were identified within an AF cohort by using Quebec administrative databases. Descriptive statistics and multivariable analysis were used to examine sex differences and temporal trends in demographic and clinical characteristics, as well as independent predictors of the ablation procedure.
  
  
  RESULTS
  A total of 2438 of 173,689 patients in the AF cohort underwent AF ablation. In the span of 10 years, the rate of AF ablation increased from 8.5 to 57.2 per million persons-an almost 7-fold increase. Patients undergoing ablation were younger than patients in the general AF cohort (57.4 ± 12.2 years vs 75.3 ± 12.0 years) and had fewer baseline comorbidities (56.7% vs 88.4%). Representing 42.9% of the general AF cohort, the annual proportion of women in the AF ablation cohort has not surpassed 30%, and men had a higher likelihood of undergoing ablation than did women (odds ratio 1.54; 95% confidence interval 1.40-1.69). Over the decade of observation, there were slight increases in patient age, comorbidities, and CHADS2 score, some of which reached clinical significance for men and/or women.
  
  
  CONCLUSIONS
  The uptake of AF ablation over 10 years has expanded, with an increasingly greater number of older patients and with increased presence of comorbidities; however, there has been no increase in the relatively low proportion of women undergoing AF ablation.
authors.affiliation: Division of Clinical Epidemiology.
authors.forename: Meytal
authors.initials: M
authors.lastname: Avgil Tsadok
authors.affiliation: Division of Clinical Epidemiology.
authors.forename: Julien
authors.initials: J
authors.lastname: Gagnon
authors.affiliation: Division of Cardiology.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Joza
authors.affiliation: Division of Clinical Epidemiology.
authors.forename: Hassan
authors.initials: H
authors.lastname: Behlouli
authors.affiliation: Division of Cardiology.
authors.forename: Atul
authors.initials: A
authors.lastname: Verma
authors.affiliation: Division of Cardiology.
authors.forename: Vidal
authors.initials: V
authors.lastname: Essebag
authors.affiliation: Division of Clinical Epidemiology; Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: louise.pilote@mcgill.ca.
authors.forename: Louise
authors.initials: L
authors.lastname: Pilote
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011159:Population Surveillance; D011667:Pulmonary Veins / Q000601:surgery*; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D013997:Time Factors
keywords: Ablation; Atrial fibrillation; Pulmonary vein isolation; Sex differences