Abstract 11315: Sex-Based Differences Following Catheter Ablation of Atrial Fibrillation: Patient Reported Outcomes and Quality of Life

Abstract

Introduction: Catheter ablation for atrial fibrillation (AF) has been established as an effective intervention to improve quality of life (QoL). Data are scarce on sex-based differences in ablation outcomes. Objective: To examine clinical outcomes and QoL following AF ablation in females vs males from a large patient-reported outcomes (PRO) database. Methods: All patients undergoing AF ablation (2013-2021) at our center were assessed for outcomes using automated PRO surveys. The primary endpoint was AF recurrence based on PRO and electrocardiographic documentation. The atrial fibrillation symptom severity scale (AFSSS) was utilized to quantify QoL response. Baseline and 1-year patient surveys were used to estimate AFSSS as well as AF burden (mean of AF duration score and AF frequency score; scale 0: no AF to 10: continuous with 9 frequencies/durations in between). Results: A total of 7,166 patients were included (29.8% female). Compared to men, women were older (67 vs 64.2 years) and more likely to have paroxysmal AF (55% vs 45%). The rate of any post-procedural complications was low (<3%) and comparable between men and women. At 3 years, the cumulative incidence of AF recurrence was higher in women compared to men (32% vs 27%; p-value<0.05); Figure. In adjusted multivariable analysis, women had a 19.9% increased risk of AF recurrence compared to men during follow-up. Similar results were observed irrespective of AF type (paroxysmal vs persistent). QoL was significantly improved at 1 year in both groups; with a comparable reduction of mean AFSSS from 13.9 to 6.1 (56.3% decrease) in women and 10.88 to 4.29 (60.5% decrease) in men. Similarly, AF burden was significantly and comparably reduced in both men and women. Conclusions: Following catheter ablation for AF, women were found to be at increased risk for AF recurrence during follow-up. Nonetheless, both men and women had significant and comparable improvement in QoL and AF burden.