Veen Danny, Verbeek Eva C, Kavousi Maryam, Huigen Jos, Mijnen-Schra Annet, Cocchieri Riccardo, Khan Muchtiar, de Groot Natasja M S
Dept. of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Dept. of Cardiothoracic Surgery and Cardiology, OLVG, Amsterdam, The Netherlands.
Int J Cardiol Heart Vasc. 2023 Aug 25;48:101262. doi: 10.1016/j.ijcha.2023.101262. eCollection 2023 Oct.
Prior studies demonstrated that female sex is associated with arrhythmia recurrence after endovascular pulmonary vein isolation (PVI). However, it is unknown if the sexes differ in outcome after video assisted thoracoscopic (VATS) PVI. The aim of this study was therefore to compare characteristics of recurrent AF episodes in a matched male and female population, using implantable loop recorders for continuous rhythm monitoring.
40 matched (based on propensity score) males (age: 60.0 ± 7.71 (45-75)) and females (age: 62.0 ± 7.0 (37-74)) were retrieved from an existing database from a prior conducted study by the cardiothoracic department of the OLVG hospital (1) containing patients who received an implantable looprecorder and underwent a VATS PVI between 2012 and 2017. Patients were continuously monitored for a period of 12 months after VATS PVI and AF characteristics were compared.
An equal number of males and females had AF episodes during all periods (P > 0.05). The number of AF episodes was higher in females, during the first 6 months (P = 0.01, P = 0.034). During the entire follow up, the total AF duration was longer in females (P = 0.01, for all periods) with shorter inter - episode intervals (P = 0.001, P = 0001, P = 0.04) and a higher AF burden (P = 0.003, P = 0001, P = 0.006). After 3 months, AF recurrences during the night were more frequently observed in female patients (P = 0.001, P = 0.001).
AF episodes occur frequently in both sexes after VATS PVI and warrant frequent rhythm monitoring. The observed sex differences in AF burden after VATS PVI, calls for intensive rhythm monitoring and aggressive treatment of recurrent AF epsiodes in females.
先前的研究表明，女性性别与血管内肺静脉隔离（PVI）后心律失常复发有关。然而，电视辅助胸腔镜（VATS）PVI术后两性的预后是否存在差异尚不清楚。因此，本研究的目的是使用植入式环路记录仪进行连续心律监测，比较匹配的男性和女性人群中房颤复发的特征。
从OLVG医院心胸外科先前进行的一项研究的现有数据库中检索出40例匹配（基于倾向评分）的男性（年龄：60.0±7.71（45 - 75岁））和女性（年龄：62.0±7.0（37 - 74岁））（1），这些患者接受了植入式环路记录仪，并在2012年至2017年期间接受了VATS PVI。VATS PVI术后对患者进行了为期12个月的连续监测，并比较了房颤特征。
在所有时间段内，男性和女性发生房颤发作的人数相等（P>0.05）。在最初的6个月内，女性的房颤发作次数更多（P = 0.01，P = 0.034）。在整个随访期间，女性的总房颤持续时间更长（所有时间段P = 0.01），发作间期更短（P = 0.001，P = 0001，P = 0.04），房颤负荷更高（P = 0.003，P = 0001，P = 0.006）。3个月后，女性患者夜间房颤复发更为频繁（P = 0.001，P = 0.001）。
VATS PVI术后两性房颤发作均较为频繁，需要频繁进行心律监测。VATS PVI术后观察到的房颤负荷性别差异，要求对女性复发性房颤发作进行强化心律监测和积极治疗。
