Walters Tomos E, Teh Andrew W, Spence Steven, Morton Joseph B, Kistler Peter M, Kalman Jonathan M
Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia; The Department of Medicine, The University of Melbourne, Melbourne, Australia.
J Cardiovasc Electrophysiol. 2014 Oct;25(10):1065-70. doi: 10.1111/jce.12465. Epub 2014 Jul 4.
Gender-based differences in the clinical nature of cardiac arrhythmias such as atrial fibrillation (AF) are well established.
The purpose of this study was to identify any such gender-based differences in the underlying pulmonary vein and atrial substrate.
Thirty-eight patients with no history of AF undergoing catheter ablation for supraventricular tachycardia (SVT) and 55 with paroxysmal or persistent AF undergoing catheter ablation of AF underwent detailed electroanatomic mapping of the pulmonary veins and atria. Refractory periods in multiple locations, sinus node function, endocardial bipolar voltage, pulmonary vein and atrial conduction, and bipolar electrogram complexity were analyzed. There were no significant between-gender differences in age or other clinical variables known to impact on the atrial or pulmonary vein substrate. In neither the AF nor the non-AF cohorts were there any significant differences in atrial or pulmonary vein refractoriness, sinus node function, any measure of PV electrophysiology, or any measure of atrial electrophysiology.
No systematic between-gender differences were observed in the PV or atrial substrate either in those with or without a history of AF, with a similar prevalence of the cardiovascular comorbidities frequently associated with atrial remodeling and AF seen in both male and female groups.
诸如心房颤动(AF)等心律失常的临床特征存在基于性别的差异,这一点已得到充分证实。
本研究的目的是确定在潜在的肺静脉和心房基质中是否存在此类基于性别的差异。
38例无房颤病史且因室上性心动过速(SVT)接受导管消融的患者,以及55例因阵发性或持续性房颤接受房颤导管消融的患者,均接受了肺静脉和心房的详细电解剖标测。分析了多个部位的不应期、窦房结功能、心内膜双极电压、肺静脉和心房传导以及双极电图复杂性。在年龄或其他已知会影响心房或肺静脉基质的临床变量方面,两性之间无显著差异。在房颤组和非房颤组中,心房或肺静脉的不应期、窦房结功能、肺静脉电生理的任何指标或心房电生理的任何指标均无显著差异。
无论有无房颤病史,在肺静脉或心房基质中均未观察到系统性的性别差异,男性和女性组中心血管合并症(常与心房重塑和房颤相关)的患病率相似。