In-hospital and 12-month follow-up outcome from the ESC-EORP EHRA Atrial Fibrillation Ablation Long-Termregistry: sex differences
Por:
Grecu M, Blomström-Lundqvist C, Kautzner J, Laroche C, Van Gelder IC, Jordaens L, Tavazzi L, Cihak R, Rubio Campal JM, Kalarus Z, Pokushalov E, Brugada-Terradellas J, Dagres N, Arbelo E and ESC-EORP EHRA Atrial Fibrillation Ablation Long-Term Registry investigators
Publicada:
1 ene 2020
Ahead of Print:
22 ago 2019
Resumen:
Aim The purpose of this study was to compare sex differences of atrial fibrillation (AF) catheter ablation (CA) and to analyse the opportunities for improved outcomes.
Methods and results All data were collected from the Atrial Fibrillation Ablation Long-Term registry, a prospective, multinational study conducted by the ESC-EORP European Heart Rhythm Association (EHRA) under the EURObservational Research Programme (ESC-EORP). A total of 104 centres in 27 European countries participated. Of 3593 included patients, 1146 (31.9%) were female. Female patients were older (61.0 vs. 56.4 years; P < 0.001), had more comorbidities (hypertension, diabetes, and obesity), more episodes of arrhythmias per month (6.9 vs. 6.2; P < 0.001), and a higher average EHRA score (2.6 vs. 2.4; P < 0.001). The duration of the procedure was shorter in females (160.1 min vs. 167.9 min; P < 0.001), irrespective of additional ablation lesions added to pulmonary vein isolation. Overall cardiovascular complications were more frequent in women than in men (5.7% vs. 3.4%; P < 0.001). Furthermore, cardiac perforations (3.8% vs. 1.3%; P = 0.011) and neurological complications (2.2% vs. 0.3%; P = 0.004) were found in females in less experienced centres than in experienced ones. On a final note, at 12 months, AF recurrence rate was similar in females and males (34.4% vs. 34.2%; P = 0.897), but more females were still on antiarrhythmic drugs (50.6% vs. 44.1%; P < 0.001) when compared with men.
Conclusion Females underwent CA procedures for AF less frequently than males throughout Europe, despite more recurrent symptoms. With the same success rate, severe acute complications remained considerable in females, especially in less experienced centres.
Filiaciones:
Grecu M:
Department of Electrophysiology, Cardiovascular Diseases Institute, Iasi, Romania
Blomström-Lundqvist C:
Department of Cardiology and Medical Science, Uppsala University, Uppsala, Sweden
Kautzner J:
Cardiology Department, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
Laroche C:
EURObservational Research Programme (EORP), European Society of Cardiology, Sophia Antipolis, France
Van Gelder IC:
Cardiology Department, University of Groningen, University Medical Center Groningen, Thoraxcenter, Groningen, The Netherlands
Jordaens L:
Erasmus Medical Center, Clinical Electrophysiology, Rotterdam, The Netherlands
Tavazzi L:
Maria Cecilia Hospital, GVM Care Research, Cotignola, Italy
Cihak R:
Cardiology Department, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
Rubio Campal JM:
Cardiology Department, Fundación Jiménez Díaz-Quirón Salud, Madrid, Spain
Kalarus Z:
Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
Pokushalov E:
"E. Meshalkin National Medical Research Center" of the Ministry of Health of the Russian Federation, Rechkunovskaya 15, 630055 Novosibirsk, Russia
Brugada-Terradellas J:
Department of Cardiology, Cardiovascular Institute, Hospital Clínic Pediatric Arrhythmia Unit, Hospital Sant Joan de Déu University of Barcelona, Villarroel 170, 08036 Barcelona, Spain
IDIBAPS, Institut d'Investigació August Pi I Sunyer (IDIBAPS), Barcelona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Dagres N:
Department of Electrophysiology, Heart Center Leipzig, University of Leipzig, Leipzig, Germany
Arbelo E:
Department of Cardiology, Cardiovascular Institute, Hospital Clínic Pediatric Arrhythmia Unit, Hospital Sant Joan de Déu University of Barcelona, Villarroel 170, 08036 Barcelona, Spain
IDIBAPS, Institut d'Investigació August Pi I Sunyer (IDIBAPS), Barcelona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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