Abstract 12357: Investigating Sex-Specific Factors Influencing Atrial Fibrillation Burden in Patients With Persistent Atrial Fibrillation: A DECAAF II Subanalysis

Abstract

Background: Atrial Fibrillation(AF) burden provides insights beyond the common binary classification of AF recurrence after catheter ablation(CA). Objective: We sought to investigate the predictors of AF burden in patients with persistent AF(PeAF) at 1 year post-CA, with a focus on sex-based differences. The analysis was conducted separately for both female and male. Methods: We examined all PeAF patients in the DECAAF II trial and divided them into 2 groups, women and men. Baseline demographics and late gadolinium enhancement magnetic resonance imaging data were reviewed. Patients were instructed to provide single-lead home ECG strips once daily. AF burden was calculated by dividing the total number of days in AF over the total number of days when strips were sent. Univariate and multivariate analysis were performed to predict AF burden beyond the 3-month blanking period. Results: We included 658 patients(20% Female,80% male) who transmitted 215825 ECG strips. The average AF burden across the population was 17%. The mean AF burden was higher in women(21%) than in men(16%)(p<0.01). In women, on univariate analysis, baseline fibrosis(p<0.05), history of stroke(p<0.01) and left atrial(LA) volume(p<0.01) were positively correlated with AF burden. After conducting a multivariate analysis, we found that baseline fibrosis(p<0.05), history of stroke(p<0.05), vascular diseases(p<0.05), and LA volume(p<0.01) were independent predictors of AF burden. In men, on univariate analysis, age(p<0.01), baseline fibrosis(p<0.01), hyperlipidemia(p<0.01) and LA volume(p<0.01) were positively correlated with AF burden. After conducting a multivariate analysis, only LA volume (p<0.01) and age(<0.01) continued to be significantly related(Table 1). Conclusion: Sex-specific management strategies are crucial for addressing AF, as our study demonstrates a significant impact of sex on predicting AF burden monitored by a single-lead handheld smartphone ECG device.