a Texas Cardiac Arrhythmia Institute , St. David's Medical Center , Austin , TX , USA.
b Department of Internal Medicine, Dell Medical School , Austin , TX , USA.
Expert Opin Pharmacother. 2018 Mar;19(4):365-374. doi: 10.1080/14656566.2018.1434144. Epub 2018 Feb 9.
Distinct differences in clinical presentation, utilization of therapy and outcome of atrial fibrillation (AF) management are observed in men vs women. This review focuses on our current knowledge on these sex-specific variations and how those impact the detection of AF and therapeutic decisions.
The current article reviews reports illustrating gender-related differences in the incidence, prevalence, clinical presentations, different risk factors, pathophysiology, therapeutic strategies, procedural parameters in catheter ablation for AF and complications and long-term outcome of ablative therapy including arrhythmia recurrence and quality of life. Some of these areas have been investigated widely providing conclusive evidences, whereas others have many unanswered questions or conflicting findings that need clarifications.
Attainment of sinus rhythm and healthy quality of life as well as prevention of complications, especially stroke, are the main goals of AF management. Sex-specific variations are evident in many areas in the spectrum of AF that should be addressed by large population-based or randomized trials to facilitate customization of AF-therapy to maximize success in both genders.
在心房颤动（AF）的管理中，男性和女性的临床表现、治疗方法的利用以及预后存在明显差异。本综述重点关注我们目前对这些性别特异性差异的认识，以及这些差异如何影响 AF 的检测和治疗决策。
本文综述了表明 AF 发生率、患病率、临床表现、不同危险因素、病理生理学、治疗策略、AF 导管消融中的程序参数以及消融治疗的并发症和长期结果（包括心律失常复发和生活质量）方面存在性别差异的报告。其中一些领域已经进行了广泛的研究，提供了确凿的证据，而其他领域仍有许多未解决的问题或相互矛盾的发现，需要进一步澄清。
恢复窦性心律和健康的生活质量以及预防并发症，特别是中风，是 AF 管理的主要目标。在 AF 谱的许多领域都存在性别特异性差异，应该通过大型基于人群或随机试验来解决这些差异，以便将 AF 治疗个性化，最大限度地提高两性的成功率。
