Department of Cardiology, Karolinska Institutet, Karolinska University Hospital; Stockholm-Sweden.
Anatol J Cardiol. 2020 Dec;24(6):405-409. doi: 10.14744/AnatolJCardiol.2020.93024.
The preferential sites for focal atrial tachycardia (FAT) are mainly in the right atrium in both sexes. However, a limited number of studies have indicated that sex differences in the localization of FAT. This study investigated possible sex differences in the distribution of FAT in a large cohort of patients referred for ablation.
From 2004 to 2019, 487 patients (298 women) were referred to our institution for ablation of FAT. A standard electrophysiological study was conducted, and isoproterenol or atropine was given when needed. Conventional catheter mapping, electroanatomic contact mapping, and noncontact mapping were used to assess the origin of ectopic atrial tachycardia.
Overall, 451 foci were successfully ablated in 436 patients (90%). Although the foci located along the crista terminalis were more common in women than in men (42% vs. 29%; p=0.023), the opposite were found in the foci located along the tricuspid annulus (5% vs. 11%; p=0.032) and the right atrial appendage (RAA) (1% vs. 3%; p=0.032). Other locations were similarly distributed in men and women. In addition, the presence of persistent FAT was more frequent in men than in women (22% vs. 5%; p<0.001). Finally, the difference in the induction pattern of FAT was also remarkable between sexes.
The distribution of FAT in women and men is different. In addition, persistent FAT seems more often in men than in women. The different distribution, persistency, and induction pattern of FAT should be considered in the successful management of this type of tachycardia.
局灶性房性心动过速（FAT）的优势部位主要在男女两性的右心房。然而，少数研究表明，FAT 的定位存在性别差异。本研究旨在调查在接受消融治疗的大量患者中，FAT 的分布是否存在性别差异。
2004 年至 2019 年，487 例患者（298 例女性）因 FAT 被转诊至我院行消融治疗。所有患者均行标准电生理检查，必要时给予异丙肾上腺素或阿托品。采用常规导管标测、电激动标测和非接触标测来评估异位房性心动过速的起源。
共有 436 例患者（90%）中的 451 个病灶成功消融。尽管心耳嵴末端起源的病灶在女性中比在男性中更常见（42% vs. 29%；p=0.023），但在三尖瓣环起源的病灶（5% vs. 11%；p=0.032）和右心耳起源的病灶（1% vs. 3%；p=0.032）中则相反。其他部位的分布在男女之间相似。此外，持续性 FAT 在男性中比在女性中更常见（22% vs. 5%；p<0.001）。最后，FAT 的诱发模式在性别之间也有显著差异。
FAT 在女性和男性中的分布不同。此外，持续性 FAT 在男性中比在女性中更常见。在成功管理这种类型的心动过速时，应考虑 FAT 的不同分布、持续性和诱发模式。
