Sex-specific outcomes and left atrial remodeling following catheter ablation of persistent atrial fibrillation: results from the DECAAF II trial

作者：Hadi Younes, Christian Sohns, Nazem Akoum, Han Feng, Eli Tsakiris, Abdel Hadi El Hajjar, Eoin Donnellan, Amitabh C. Pandey, Chanho Lim, Ghassan Bidaoui, Mario Mekhael, Charbel Noujeim, Nour Chouman, Ala Assaf, Ghaith Shamaileh, Francisco Tirado Polo, Mayana Bsoul, Lilas Dagher, Omar Kreidieh, Swati Rao, Philipp Sommer, Mathias Forkmann, Johannes Brachmann, Nassir F. Marrouche, Christian Mahnkopf · 发表于：Journal of Interventional Cardiac Electrophysiology · 年份：2024 · DOI：10.1007/s10840-024-01831-w · 被引用次数：11 · 研究领域：Atrial Fibrillation Management and Outcomes、Cardiovascular Disease and Adiposity、Cardiac Arrhythmias and Treatments

BACKGROUND: Catheter ablation is recognized as an effective treatment for atrial fibrillation (AF). Despite its effectiveness, significant sex-specific differences have been observed, which influence the outcomes of the procedure. This study explores these differences in a cohort of patients with persistent AF. We aim to assess sex differences in baseline characteristics, symptoms, quality of life, imaging findings, and response to catheter ablation in patients with persistent AF. METHODS: This post hoc analysis of the DECAAF II trial evaluated 815 patients (161 females, 646 males). Between July 2016 and January 2020, participants were enrolled and randomly assigned to receive either personalized ablation targeting left atrial (LA) fibrosis using DE-MRI in conjunction with pulmonary vein isolation (PVI) or PVI alone. In this analysis, we aimed to compare female and male patients in the full cohort in terms of demographics, risk factors, medications, and outcomes such as AF recurrence, AF burden, LA volume reduction assessed by LGE-MRI before and 3 months after ablation, quality of life assessed by the SF-36 score, and safety outcomes. Statistical methods included t-tests, chi-square, and multivariable Cox regression. RESULTS: Females were generally older with more comorbidities and experienced higher rates of arrhythmia recurrence post-ablation (53.3% vs. 40.2%, p < 0.01). Females also showed a higher AF burden (21% vs. 16%, p < 0.01) and a smaller reduction in left atrial vo...