Analysis of gender differences and influencing factors in postoperative recurrence of catheter ablation for different types of atrial fibrillation
DU Wei
ZHU Wen-wu
YANG Hao
DONG Qing-shan
HAN Bing
Abstract：Objective To investigate gender differences and influencing factors in arrhythmia recurrence after catheter ablation for different types of atrial fibrillation(AF).Methods The AF patients who underwent de novo catheter ablation at Xuzhou Central Hospital from May 2013 to April 2021 were analyzed retrospectively.The patients were categorized into the paroxysmal AF(PAF)and persistent AF(PeAF)groups based on AF characteristics.The general clinical data,procedural parameters and follow-up outcomes were recorded to analyze gender differences in clinical,procedural and prognostic profiles.Univariate and multivariate Cox regression models were used to identify the predictors of arrhythmia recurrence;and Kaplan-Meier curves were used to assess arrhythmia-free survival rates.Results Among 857 enrolled patients[median age(61.4±10.2)years;37.3％female;55.5％PAF],females were significantly older(P＜0.05),with higher PAF prevalence and more non-pulmonary vein trigger ablations.Cardiac structural parameters[left atrial diameter(LAD),left atrial volume(LAV),and left ventricular end-diastolic diameter(LVEDD)]were smaller in females(P＜0.05).In the PAF group,left atrial volume index(LAVI)showed no gender difference(P＞0.05),whereas in the PeAF group,females exhibited higher LAVI(P＜0.05).All the patients achieved successful pulmonary vein isolation[median procedure time:118(90,162)minutes].Over a median follow-up of 53(37,72)months,35.4％(303/857)experienced atrial tachyarrhythmia(ATa)recurrence,with no overall gender difference(34.5％vs.36.9％,P=0.473).However,recurrence rates diverged by AF type:males trended higher in the PAF group(37.4％vs.30.1％,P=0.096),whereas females had significantly higher recurrence in the PeAF group(49.1％vs.31.5％,P=0.001).Multivariate analysis revealed AF duration and LAVI were the independent predictors of recurrence in the entire cohort.For PAF patients,LAVI was the sole predictor.In PeAF patients,AF duration,LAVI and female sex were the independent predictors of recurrence.Conclusions Gender disparity exists in post-ablation arrhythmia recurrence across AF types,with females exhibiting significantly higher recurrence rates in PeAF.
Keywords：Atrial fibrillationRadiofrequency catheter ablationRecurrenceGender
Publication Date：2025-05-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 399-404 )