Department of Cardiology, Westmead Hospital, Westmead Applied Research Centre, University of Sydney, Darcy Road, Westmead, NSW, Australia.
J Interv Card Electrophysiol. 2023 Jan;66(1):203-213. doi: 10.1007/s10840-022-01188-y. Epub 2022 Mar 30.
Women are under-represented in many key studies and trials examining outcomes of catheter ablation (CA) for ventricular arrhythmias (VA). We compared characteristics between men and women undergoing their first catheter ablation for VA at a single centre over 10 years.
The clinical, procedural characteristics and outcomes of 287 consecutive patients (male = 182, female = 105), undergoing their first CA at our centre over 10 years were compared according to sex and underlying heart disease.
In the ablation population, women were younger, had fewer co-morbidities, were less likely to have ischemic cardiomyopathy (ICM) and VA storm and were more likely to have idiopathic VA and premature ventricular complexes as the indication for ablation (P < 0.05 for all). Amongst idiopathic and non-ischemic cardiomyopathy (NICM) subgroups, baseline characteristics were similar; amongst ICM, women were younger and had higher numbers of drug failure pre-ablation (P = 0.05). Women were similar to men in all procedural characteristics, acute procedural success and complications, regardless of underlying heart disease. At median follow-up of 666 days, VA-free survival, overall mortality and survival free of death or transplant were comparable in both groups. Sex was not a predictor of these outcomes, after accounting for clinical and procedural characteristics.
Women represented 36% of the real-world population at our centre referred for CA of VA. There are key differences in clinical features of women versus men referred for VA ablation. Despite these differences, VA ablation in women can be accomplished with similar success and complication rates to men, regardless of underlying heart disease.
在许多研究和试验中，女性在检查导管消融（CA）治疗室性心律失常（VA）的结果方面代表性不足。我们比较了 10 年来在一家中心接受首次导管消融治疗 VA 的男性和女性患者的特征。
根据性别和潜在心脏病，比较了 287 例连续患者（男性 182 例，女性 105 例）在 10 年内首次在我们中心接受 CA 的临床、手术特征和结局。
在消融人群中，女性年龄较小，合并症较少，缺血性心肌病（ICM）和 VA 风暴的发生率较低，特发性 VA 和室性早搏作为消融指征的发生率较高（所有 P<0.05）。在特发性和非缺血性心肌病（NICM）亚组中，基线特征相似；在 ICM 中，女性年龄较小，消融前药物治疗失败的次数更多（P=0.05）。女性在所有手术特征、急性手术成功率和并发症方面与男性相似，无论潜在心脏病如何。在中位数为 666 天的随访中，两组的 VA 无复发生存率、总死亡率和无死亡或移植的生存率相当。在考虑了临床和手术特征后，性别并不是这些结果的预测因素。
在我们中心接受 VA 消融治疗的患者中，女性占真实世界人群的 36%。女性与男性在 VA 消融治疗方面的临床特征存在关键差异。尽管存在这些差异，但女性的 VA 消融治疗可以取得与男性相似的成功率和并发症发生率，无论潜在心脏病如何。
