Arrhythmias & electrophysiology
Sex differences in atrial remodeling and atrial fibrillation recurrence after catheter ablation
Authors' conclusion
Female sex was an independent predictor of AF recurrence. After adjusting for confounders, women showed decreased LA strain and higher stiffness, suggesting intrinsic disparities in atrial remodeling that may explain their higher recurrence rates.
Study context
- Population
- Patients undergoing first-time catheter ablation (CA) for atrial fibrillation (AF)35% women, propensity score (PS)-matched cohort of 113 patient pairs
- Participants
- 560 patients
- Exposure
- AF recurrence rates after an 8-week blanking period were compared between sexes
- Outcome
- Age
Methodological detailspropensity score (PS) matching
- Propensity score (PS) matching
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Hazard ratio (95% CI) | |
|---|---|---|
| AF recurrence · median follow-up of 19 monthsWomenvs MenAfter adjusting for confounders | 1.75 (1.21–2.53) | |
| AF recurrence · median follow-up of 19 monthsWomenvs MenAfter PS matching | 1.73 (1.05–2.87) | |
| 0.20.5125Hazard ratio (log scale) |
Modification of the prognostic effect of sex
- Baseline characteristics did not modify the prognostic effect of sex on AF recurrence
Left atrial (LA) structure and function (PS-matched cohort)
- Women showed lower LA strain, increased LA stiffness, and more low-voltage areas, despite similar LA dimensions
- PS-matched cohort of 113 patient pairs
Original publication
Sex differences in atrial remodeling and atrial fibrillation recurrence after catheter ablation. Heart Rhythm. Published 6 February 2025. doi:10.
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