Abstract 12228: Understanding the Gender Gap in Patients Undergoing Atrial Fibrillation Ablation: Women Delay Ablation Until Functionally Limited and Symptoms Are Severe

Abstract

Introduction: The incidence of atrial fibrillation (AF) is nearly equivalent in men and women. Yet, existing literature indicates a gender gap in patients with atrial fibrillation presenting for ablation. We examine this discrepancy among patients undergoing AF ablation at The University of North Carolina hospital. Hypothesis: We hypothesized that gender differences in AF symptoms and functional capacity could account for the gender gap in patients undergoing AF ablation. Methods: A study of 178 consecutive patients presenting for AF ablation was conducted between October 2014 and May 2015. Prior to undergoing ablation, consenting patients completed the Duke Activity Status Index (DASI) evaluating functional capacity and the Atrial Fibrillation Effect on Quality-of-Life Questionnaire Tool (AFEQT) assessing AF-specific quality of life, symptom severity, treatment concern, and daily activities. Questionnaire data was analyzed with baseline demographics and comorbidities for gender differences. Results: Of 178 patients completing the baseline questionnaire, the proportion of men pursuing ablation (n=129, 72.5%) largely outweighed that of women (n=49, 27.5%). There were no gender differences in baseline demographics with the exception of significantly higher prevalence of obstructive sleep apnea (p<0.001) and persistent AF in men (p<0.05). Women presented for AF ablation with significantly lower functional capacity (p<0.001), higher AF symptom severity (p<0.05) and lower overall AF quality of life (p<0.05) in comparison to men (Table). Conclusions: Our findings suggest that women do not present for AF ablation until symptoms are severe and functional capacity is low, likely contributing to the gender gap in AF ablation referrals. Whether this disparity is due to patient or provider factors requires further evaluation. Education of patients and providers regarding the potential efficacy and risks of ablation may help to bridge this gender gap.