Tan Jian Liang, Johnson Linda, Dziubinski Marek, Napiorkowski Natan, Witkowska Olga, Slusarczyk Magdalena E, Healey Jeff S, Russo Andrea M
Cardiovascular Division, Cooper University Health System, Cooper Medical School of Rowan University, United States of America.
Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.
Am Heart J Plus. 2022 Sep 16;22:100208. doi: 10.1016/j.ahjo.2022.100208. eCollection 2022 Oct.
Women are less likely to receive oral anticoagulation or ablation for treatment of atrial fibrillation (AF). Identification of sex differences in arrhythmia characteristics and symptoms may lead to a better understanding of potential reasons for these differences.
To determine sex differences in AF with respect to heart rate, duration, burden, and symptoms in patients undergoing mobile cardiac telemetry (MCT) monitoring.
All patients who registered for ≤30-day MCT using PocketECG (MediLynx) in the USA in 2017 were included (n = 27,512, 58 % women). PocketECG records and transmits a three-lead ambulatory electrocardiogram (ECG) with real-time beat-to-beat analysis. Sex-related differences were analyzed with Chi2 and Spearmans rho.
Fewer women than men were diagnosed with AF lasting ≥30s (13.7 % versus [vs] 19.0 %, p < 0.001). AF burden was lower in women in all age groups <90 years (all p < 0.01). Women were older at the time of AF diagnosis (median 76 vs 73 years, p < 0.001), had faster heart rate during AF (mean: 104.7 ± 26.0 vs 96.7 ± 26.7 bpm, p < 0.001), and shorter AF duration (mean: 96.2 ± 176.0 vs 121.6 ± 189.9 min, p < 0.001). There was a non-significant trend toward more symptoms (such as dizziness, racing heart, fatigue, or palpitations) during AF in women compared to men (46.5 % vs 43.7 %, p = 0.062).
AF was less prevalent and occurred at lower burdens in women than men in each age strata. Despite faster heart rates in AF in women, there were no significant sex differences in reported symptoms during AF. Sex differences in therapy cannot be explained by differences in symptoms or rates in AF.
Real-world data on sex differences in AF using a 30-day MCT monitoring device remain scarce. We aim to determine the sex differences in AF with respect to prevalence, burden, heart rate, and symptom in patients undergoing ≤30-day MCT monitoring. Our data analysis suggests that fewer women than men had AF, women were older at diagnosis of AF, and women with AF had higher mean heart rate, shorter mean AF duration, and lower mean AF burden than men. Further studies are needed to examine reasons for sex differences, specifically in relation to AF therapy and its impact on clinical outcomes.
女性接受口服抗凝治疗或房颤（AF）消融治疗的可能性较低。识别心律失常特征和症状方面的性别差异可能有助于更好地理解这些差异的潜在原因。
确定接受动态心脏遥测（MCT）监测的患者在房颤方面心率、持续时间、负荷和症状的性别差异。
纳入2017年在美国使用PocketECG（MediLynx）进行≤30天MCT登记的所有患者（n = 27512，58%为女性）。PocketECG记录并传输三导联动态心电图（ECG），并进行实时逐搏分析。采用卡方检验和斯皮尔曼等级相关分析性别相关差异。
诊断为房颤持续≥30秒的女性少于男性（13.7%对19.0%，p < 0.001）。在所有<90岁年龄组中，女性的房颤负荷较低（所有p < 0.01）。女性房颤诊断时年龄较大（中位数76岁对73岁，p < 0.001），房颤期间心率较快（平均：104.7±26.0对96.7±26.7次/分，p < 0.001），房颤持续时间较短（平均：96.2±176.0对121.6±189.9分钟，p < 0.001）。与男性相比，女性在房颤期间出现更多症状（如头晕、心跳加速、疲劳或心悸）的趋势不显著（46.5%对43.7%，p = 0.062）。
在各年龄层中，女性房颤的患病率较低，且负荷也低于男性。尽管女性房颤时心率较快，但房颤期间报告的症状在性别上无显著差异。治疗方面的性别差异无法用房颤症状或心率差异来解释。
使用30天MCT监测设备获取的关于房颤性别差异的真实世界数据仍然稀缺。我们旨在确定接受≤30天MCT监测的患者在房颤患病率、负荷、心率和症状方面的性别差异。我们的数据分析表明，诊断为房颤的女性少于男性，女性房颤诊断时年龄较大，且女性房颤患者的平均心率较高、平均房颤持续时间较短且平均房颤负荷低于男性。需要进一步研究来探讨性别差异的原因，特别是与房颤治疗及其对临床结局的影响相关的原因。
