195: Women with atrial flutter differ from men

Abstract

The management and prognosis of heart diseases (HD) or arrhythmias may depend on the patient gender. The purpose of the study was to look for the influence of gender on the indications and the long-term results of ablation of atrial flutter (AFl). 965 patients, 743 males, 222 females (23%), mean age 64 ± 12 years were consecutively referred for radiofrequency ablation of recurrent or poor-tolerated AFL Clinical history, other arrhythmias as atrial fibrillation (AF), data of echocardiography were collected. The patients were followed from 3 months up to 10 years. Women tended to be older than men (65.5±12 vs 64±11.5 years) (p< 0.08). Underlying HD was as frequent in women as in men (76%). HD nature differed: women had more congenital HD (10 vs 2%, p<0.0001), more valvular HD (17.5 vs 10% p<0.002) and less respiratory failure (4.5 vs 10%) (p<0.01), less ischemic HD (5 vs 20%)(p<0.0000) than men. Hypertensive HD, dilated cardiomyopathy or various HD's did not differ. Previous history of AF was more frequent in women (31.5%) than in men (26%) (p<0.012). AFl-related rhythmic cardiomyopathy tended to be less frequent in women than in men (4 vs 8%) (p<0.07). Presentation with 1/1 AFl was as frequent in women as in men (10% vs 7%). AFl ablation-related major complications as complete AV block, death or cardiac shock were more frequent in women than in men (4 vs 1%)(p<0.004). After 3±3 years, AFl recurrences tended to be less frequent in women than in men (8.5 vs 13%)(p<0.06). AF occurrence was more frequent in women than in men (24 vs 14%)(p<0.0002). Among these patients 66% of women and men had no history of AF before AFl ablation. Their risk of AF remains higher in women than in men (16% vs 8%)(p<0.007). There gender-related differences in the prevalence, clinical presentation, ablation-related complications and AF incidence. AFL is less common in women than in men, despite similar age and as frequent underlying HD. The risk of AFl ablation-related major complications is higher in women than in men. Women have more frequently history of AF and an independent higher risk than men of developing AF after ablation of atrial flutter.