Arrhythmias & electrophysiologyCross-sectional study
Sex differences in atrial fibrillation-related atrial remodelling assessed by electroanatomic mapping and biopsy
- Cross-sectional study
Authors' conclusion
Despite consistently lower voltage in women, no significant histopathological sex differences were identified in non-valvular cases, likely due to their inherently smaller atrial mass.
Study context
- Population
- Patients undergoing atrial fibrillation (AF) ablation with right atrial biopsy and high-density voltage mapping; controls without AF undergoing supraventricular tachycardia ablationAF
- Participants
- 282 patients
- Exposure
- Women vs men
- Womenn = 81
- Outcome
- Voltage at biopsy site (Vbiopsy), global left atrial voltage (VGLA) and histopathological parameters
Main finding
As reported in the abstract
Voltage, AF
| Group | Vbiopsy | VGLA |
|---|---|---|
| Women | 7.4 ± 2.6 mV | 4.9 ± 1.8 mV |
| Men | 9.3 ± 3.2 mV | 6.7 ± 2.2 mV |
- Women vs Men: P < 0.001 — Vbiopsy
- Women vs Men: P < 0.001 — VGLA
Observational data: associations, not effects.
Further findings
| Outcome | Women | Men | P value |
|---|---|---|---|
| Voltage, patients without AF | |||
| Vbiopsy | 7.8 ± 2.7 mV | 10.9 ± 2.6 mV | P < 0.001 |
| VGLA | 7.3 ± 1.7 mV | 9.4 ± 1.4 mV | |
| Small cardiomyocytes (<10 μm), minimal histological change (n=34) | 37% (SD 23%) | 20% (SD 19%) | P = 0.029 |
Vbiopsy–VGLA correlation
- Positive correlation in both groups (r)
- 0.70 and 0.60, P < .001
Original publication
Sex differences in atrial fibrillation-related atrial remodelling assessed by electroanatomic mapping and biopsy. Eur Heart J. Published 25 September 2025. doi:10.1093/eurheartj/ehaf768
Summarised from the published abstract; every number is checked against it