Forleo Giovanni B, Tondo Claudio, De Luca Lucia, Dello Russo Antonio, Casella Michela, De Sanctis Valerio, Clementi Fabrizio, Fagundes Rafael Lopes, Leo Roberto, Romeo Francesco, Mantica Massimo
Arrhythmia and Electrophysiology Center, St Ambrogio Clinical Institute, Via Luigi Faravelli, 16-20149 Milan, Italy.
Europace. 2007 Aug;9(8):613-20. doi: 10.1093/europace/eum144. Epub 2007 Jul 18.
Women have an increased risk for atrial fibrillation (AF)-related complications and there is evidence towards a reduced efficacy of the rhythm control strategy than men. A catheter-based strategy is therefore widely attractive, but the impact of gender on catheter ablation (CA) of AF remains undefined.
We included 221 consecutive patients (150 men) who underwent CA of drug-refractory AF. Gender differences in clinical presentation and outcomes were compared. Women were older (P = 0.002), had a longer history of AF (P = 0.04), and were more likely to have hypertension (P = 0.04). Moreover, a concomitant valvular heart disease tended to be more common in women (32.4 vs. 23.3%; P = 0.28) and left atrium dimensions were significantly larger (P = 0.003). However, acute success rate and complications rate were similar between genders. After 22.5 +/- 11.8 months of follow-up, the overall freedom from arrhythmia recurrences was similar (83.1 vs. 82.7% in men), and a similar improvement in SF-36 quality of life scores was achieved in both groups.
Women are referred for AF ablation later with a more complex clinical pre-operative presentation. Despite this higher risk profile in women, no differences were detected in clinical outcomes. Our findings indicate that CA of AF appears to be safe and effective in women as in men.
女性发生心房颤动（AF）相关并发症的风险增加，且有证据表明节律控制策略对女性的疗效低于男性。因此，基于导管的策略具有广泛吸引力，但性别对AF导管消融（CA）的影响仍不明确。
我们纳入了221例连续接受药物难治性AF导管消融的患者（150例男性）。比较了临床表现和结局的性别差异。女性年龄更大（P = 0.002），AF病史更长（P = 0.04），且更易患高血压（P = 0.04）。此外，女性合并瓣膜性心脏病的情况往往更常见（32.4%对23.3%；P = 0.28），左心房尺寸显著更大（P = 0.003）。然而，性别之间的急性成功率和并发症发生率相似。经过22.5±11.8个月的随访，总体无心律失常复发率相似（男性为83.1%，女性为82.7%），两组在SF - 36生活质量评分方面均有类似改善。
女性接受AF消融的时间较晚，术前临床情况更复杂。尽管女性的风险更高，但临床结局未发现差异。我们的研究结果表明，AF导管消融在女性中似乎与男性一样安全有效。
