Singh Sheldon M, D'Avila Andre, Aryana Arash, Kim Young-Hoon, Mangrum J Michael, Michaud Gregory F, Dukkipati Srinivas R, Heist E Kevin, Barrett Conor D, Thorpe Kevin E, Reddy Vivek Y
Schulich Heart Program, Sunnybrook Health Science Center, Faculty of Medicine, University of Toronto, Toronto, Canada.
Helmsley Cardiac Arrhythmia Service, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
J Cardiovasc Electrophysiol. 2016 Nov;27(11):1259-1263. doi: 10.1111/jce.13051. Epub 2016 Aug 30.
Atrial fibrillation (AF) ablation is less frequently performed in women when compared to men. There are conflicting data on the safety and efficacy of AF ablation in women. The objective of this study was to compare the clinical characteristics and outcomes in a contemporary cohort of men and women undergoing persistent AF ablation procedures.
A total of 182 men and 53 women undergoing a first-ever persistent AF catheter ablation procedure in The Modified Ablation Guided by Ibutilide Use in Chronic Atrial Fibrillation (MAGIC-AF) trial were evaluated. Clinical and procedural characteristics were compared between each gender. The primary efficacy endpoint was the 1-year single procedure freedom from atrial arrhythmia off anti-arrhythmic drugs. Women undergoing catheter ablation procedures were older than men (P < 0.001). The duration of AF and associated co-morbidities were similar between both genders. Single procedure drug-free atrial arrhythmia recurrence occurred in 53% of the cohort with no difference based on gender (men = 54%, women = 53%; P = 1.0). Procedural (P = 0.04), fluoroscopic (P = 0.02), and ablation times (P = 0.003) were shorter in women compared to men. Periprocedural complications and postablation improvement in quality of life were similar between men and women.
Women undergoing a first-ever persistent AF ablation procedure were older but had similar clinical outcomes and complications when compared with men.
与男性相比，女性较少接受房颤（AF）消融治疗。关于女性房颤消融的安全性和有效性的数据存在冲突。本研究的目的是比较当代接受持续性房颤消融手术的男性和女性队列的临床特征和结局。
在“依布利特用于慢性房颤的改良消融指导（MAGIC-AF）”试验中，对总共182名首次接受持续性房颤导管消融手术的男性和53名女性进行了评估。比较了每种性别的临床和手术特征。主要疗效终点是在停用抗心律失常药物的情况下，单次手术1年无房性心律失常。接受导管消融手术的女性比男性年龄大（P<0.001）。房颤持续时间和相关合并症在两性之间相似。53%的队列出现单次手术无药物性房性心律失常复发，基于性别无差异（男性=54%，女性=53%；P=1.0）。与男性相比，女性的手术时间（P=0.04）、透视时间（P=0.02）和消融时间（P=0.003）更短。围手术期并发症和消融后生活质量改善在男性和女性之间相似。
与男性相比，首次接受持续性房颤消融手术的女性年龄更大，但临床结局和并发症相似。
