Sex-based long-term outcome for atrial fibrillation patients post catheter ablation.

BACKGROUND

Previous studies have demonstrated sex-based disparities in atrial fibrillation (AF) recurrence and procedural complications post-catheter ablation among female patients; however, sex-specific long-term outcomes remain insufficiently characterized.

OBJECTIVES

This study aimed to evaluate long-term outcomes of AF recurrence and major adverse cardiovascular/cerebrovascular events (MACE) after catheter ablation, with the objectives of identifying sex-specific risk factors and providing evidence for personalized clinical strategies.

METHODS

We conducted a retrospective analysis using data from a prospectively observational registry of AF ablation procedures at our institution from 2015 to 2020. Patients were followed up for MACE and AF recurrence. The risk factors of AF recurrence and MACE were further explored.

RESULTS

The cohort comprised 2293 patients (62.8 % male; 37.2 % female) with a median follow-up of 50.36 months. Female patients demonstrated significantly higher AF recurrence rates compared to males (HR 1.305, 95 % CI 1.101 to 1.547; p = 0.0014), a disparity consistent across early (<1 year from diagnosis) and late ablation subgroups (both p < 0.05). In contrast, MACE incidence did not differ by sex (p = 0.23). Multivariable analysis identified female sex (adjust HR 1.358, p = 0.003), diabetes mellitus (HR 1.413, p = 0.005), and left atrial diameter ≥40 mm (HR 1.356, p = 0.001) as independent predictors of recurrence CONCLUSIONS: Sex differences significantly impact the long-term outcomes of AF recurrence, but not MACE rates post-catheter ablation. The study highlights the necessity to integrate sex considerations into AF management strategies.