女性心房颤动导管消融的结果和并发症。
Outcomes and complications of catheter ablation for atrial fibrillation in females.
机构信息
St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, TX, USA.
出版信息
Heart Rhythm. 2010;7(2):167-72. doi: 10.1016/j.hrthm.2009.10.025. Epub 2009 Oct 23.
BACKGROUND
Most atrial fibrillation (AF) ablation studies have consisted predominantly of males; accordingly, there is a paucity of information on the safety and efficacy of catheter ablation in a large cohort of female AF patients.
OBJECTIVE
The purpose of this study was to evaluate catheter ablation for AF in female patients.
METHODS
From January 2005 to May 2008, 3265 females underwent pulmonary vein antrum isolation. Success rates, patient profiles, and complications were collected.
RESULTS
Approximately 16% of our population was female (P <.001). Females were older (59 +/- 13 vs. 56 +/- 19 years; P <.01) and had a lower prevalence of paroxysmal atrial fibrillation (PAF; 46% vs. 55%; P <.001). Females failed more antiarrhythmics (4 +/- 1 vs. 2 +/- 3; P = .04) and were referred later for catheter ablation (6.51 +/- 7 vs. 4.85 +/- 6.5 years; P = .02) than males. More females failed ablation (31.5% vs. 22.5%; P = .001) and had nonantral sites of firing than males (P <.001). Female patients had 11 (2.1%) hematomas versus 27 (0.9%) in males.
CONCLUSIONS
Five times as many males underwent catheter ablation than females. Females failed more ablations possibly because of a higher prevalence of nonantral firing, non-PAF, and longer history of AF. Females had more bleeding complications than males.
背景
大多数房颤（AF）消融研究主要由男性组成；因此，关于女性 AF 患者中导管消融的安全性和有效性的信息很少。
目的
本研究旨在评估女性患者的导管消融治疗房颤。
方法
从 2005 年 1 月至 2008 年 5 月，3265 名女性接受了肺静脉窦隔离。收集成功率、患者特征和并发症。
结果
我们的人群中约有 16%是女性（P<.001）。女性年龄较大（59±13 岁比 56±19 岁；P<.01），阵发性房颤（PAF）的发生率较低（46%比 55%；P<.001）。女性抗心律失常药物的失败率更高（4±1 比 2±3；P=0.04），并较男性晚（6.51±7 比 4.85±6.5 年；P=0.02）接受导管消融。女性消融失败的比例（31.5%比 22.5%；P=0.001）和非肺静脉窦的放电部位比男性更多（P<.001）。女性患者有 11 例（2.1%）血肿，而男性有 27 例（0.9%）。
结论
接受导管消融的男性是女性的五倍。女性消融失败的比例更高，可能是因为非肺静脉窦放电、非阵发性房颤和房颤病史较长的比例较高。女性出血并发症比男性多。
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