Arrhythmias & electrophysiology
Sex-based differences in bi-atrial voltage in atrial fibrillation: a multimodal and digital twin approach to distinguish physiological variation from pathological remodelling
Authors' conclusion
Women with AF exhibit lower bi-atrial voltages despite comparable substrate characteristics and AF mechanisms, suggesting that observed voltage differences may reflect physiological variation rather than pathological remodelling. Sex-specific voltage thresholds may improve the accuracy of substrate assessment and facilitate personalised treatment.
Study context
- Population
- Patients scheduled for atrial fibrillation (AF) ablation31% female, 1:1 propensity score-matched cohort n=44
- Participants
- Seventy patients
- Exposure
- Sex-based differences in voltage, contextualised by complementary measures of substrate remodelling and AF mechanisms
- Outcome
- Mean bipolar voltage, left atrium
Methodological detailspropensity score matching, patient-specific digital twins, cardiac MRI
- Propensity score matching
- Patient-specific digital twins
- Cardiac MRI
Main finding
As reported in the abstract
P = 0.028
Observational data: associations, not effects.
Further findings
Mean bipolar voltage, right atrium · lower in women
P = 0.025
Mean left atrial voltage cutoff calibrated to 12-month arrhythmia recurrence status · exploratory receiver operating characteristic analysis
- Mean bipolar voltage, right atrium: 1:1 propensity score matched (n=44)
Other structural, functional, or electrophysiological parameters; digital twin AF termination, phase singularity count, wave dynamics, response to virtual ablation
- No significant differences in propensity score-matched analyses
Original publication
Summarised from the published abstract; every number is checked against it