Differences in catheter ablation of paroxysmal atrial fibrillation between males and females

article i nfo Background: Catheter ablation (CA) has become a standard treatment for patients with atrial fibrillation (AF). However, gender-related differences associated with CA of paroxysmal AF (PAF) remain unclear. Methods: Wecompared1124consecutivepatients(meanage,61±10 years;male,n=864)withPAFscheduled for CA between the genders. Results: Females were significantly older (pb0.0001), and had a lower body-mass-index (p=0.02), smaller left atrial dimension (LAD; p=0.04), larger LAD indexed by the body-surface-area (LADI; pb0.0001) and better left ventricular ejection fraction (pb0.0001) at baseline. Ischemic heart disease (p=0.007) was more frequent in males, whereas hypertrophic cardiomyopathy (p=0.007) and mitral stenosis (p=0.001) were more frequent in females. More additional procedures were performed to eliminate non-pulmonary vein foci in females than males (pb0.05),but thoselocations were similar between the genders. The incidence of procedure-related com- plicationswas similar between genders (p=0.73).Sinus rhythmwassimilarlymaintainedbetweenfemales and males after the first CA (56.4% vs. 59.3% at 5 years, p=0.24), but was significantly lower in females after the last CA (76.5% vs. 81.3% at 5 years, p=0.007). More females did refuse multiple CA procedures (especially a second one) than males (37.8% in females vs. 27.4% in males, p=0.02). The age (HR, 0.98/y, p=0.01), duration of AF (HR, 1.04/y, p=0.0001), number of failed anti-arrhythmic-drugs (HR, 1.10, p=0.03) and LADI (HR, 1.89 per 10 mm/m 2