Hermida Alexis, Burtin Jacqueline, Kubala Maciej, Fay Floriane, Lallemand Pierre-Marc, Buiciuc Otilia, Lieu Audrey, Zaitouni Mustafa, Beyls Christophe, Hermida Jean-Sylvain
Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France.
Clinique de l'Europe, Amiens, France.
Front Cardiovasc Med. 2022 May 18;9:893553. doi: 10.3389/fcvm.2022.893553. eCollection 2022.
The literature data on the outcomes of radiofrequency catheter ablation for atrial fibrillation (AF) in women are contradictory.
To determine and compare the outcomes and complications of cryoballoon pulmonary vein isolation (cryo-PVI) in men vs. women, and to identify predictors of atrial tachyarrhythmia (ATa) recurrence.
We included all consecutive patients having undergone cryo-PVI for the treatment of symptomatic AF in our center since 2012. Peri-operative complications were documented. All patients were prospectively monitored for the recurrence of ATa, and predictors were assessed.
A total of 733 patients were included (550 men (75%) and 183 (25%) women). Paroxysmal AF was recorded in 112 (61%) female patients and 252 male patients (46%; < 0.001). Female patients were older ( < 0.001) and had a greater symptom burden ( = 0.04). Female patients were more likely to experience complications ( = 0.02). After cryo-PVI for paroxysmal AF, 66% of the female patients and 79% of the male patients were free of ATa at 24 months ( = 0.001). Female sex was the only independent predictive factor for ATa recurrence (hazard ratio [95% confidence interval] = 1.87 [1.28; 2.73]; = 0.001). After cryo-PVI for non-paroxysmal AF, 37% of the male patients and 39% of the female patients were free of ATa at 36 months ( = 0.73). Female patients were less likely than male patients to undergo repeat ablation after an index cryo-PVI for non-paroxysmal AF ( = 0.019).
A single cryo-PVI procedure for paroxysmal AF was significantly less successful in female patients than in male patients. Overall, the complication rate was higher in women than in men.
关于女性心房颤动（AF）射频导管消融术结果的文献数据相互矛盾。
确定并比较男性与女性冷冻球囊肺静脉隔离术（cryo-PVI）的结果及并发症，并确定房性快速性心律失常（ATa）复发的预测因素。
纳入自2012年以来在本中心接受cryo-PVI治疗症状性AF的所有连续患者。记录围手术期并发症。对所有患者进行前瞻性ATa复发监测，并评估预测因素。
共纳入733例患者（550例男性（75%）和183例女性（25%））。112例（61%）女性患者和252例男性患者（46%）记录为阵发性AF（P<0.001）。女性患者年龄更大（P<0.001）且症状负担更重（P=0.04）。女性患者更易发生并发症（P=0.02）。阵发性AF接受cryo-PVI治疗后，24个月时66%的女性患者和79% 的男性患者无ATa（P=0.001）。女性是ATa复发的唯一独立预测因素（风险比[95%置信区间]=1.87[1.28；2.73]；P=0.001）。非阵发性AF接受cryo-PVI治疗后，36个月时37%的男性患者和39%的女性患者无ATa（P=0.73）。非阵发性AF首次cryo-PVI治疗后，女性患者比男性患者接受再次消融的可能性更小（P=0.019）。
阵发性AF单次cryo-PVI手术在女性患者中的成功率显著低于男性患者。总体而言，女性的并发症发生率高于男性。
