Abstract

Background: Autoimmune disorders (AuID) are pro-inflammatory conditions and inflammation is known to promote atrial fibrillation (AF). We evaluated the arrhythmia profile in female AF patients with vs without AuID. Methods: Consecutive female patients undergoing their first catheter ablation at our center were included in the analysis and divided into two groups; group 1: with AuID (n=192) and group 2: no AuID (n=2324). All received PV isolation + isolation of left atrial posterior wall and superior vena cava. Additionally, non-PV triggers identified by isoproterenol-challenge were ablated in all.Patients were included in group 1 if they had an established diagnosis of Type 1 Diabetes (DM), rheumatoid arthritis (RA), Lupus, inflammatory bowel disease (IBD), Psoriasis, Sjogren syndrome, Grave’s disease or Celiac disease. Results: Baseline characteristics of the study groups are provided in table 1. Most prevalent AuID were DM (56, 29%), RA (52, 27%), Lupus (35, 18.2%) and IBD (40, 20.8%). Patients with AuID were significantly younger and more had non-paroxysmal AF. They also had larger LA diameter and lower LVEF compared to the group with no AuID. Significantly higher number of non-PV triggers were detected in group 1 patients (149 (77.6%) vs 883 (38%), p<0.001). After 2.5 years of follow-up, 139 (72.4%) and 1775 (76.3%) patients from group 1 and 2 were arrhythmia-free off-AAD (p=0.1). Conclusion: Women with autoimmune diseases experienced AF at an earlier age with significantly more non-paroxysmal AF compared to those without. However, similar ablation success was observed in both groups that could be attributed to the ablation strategy including all detectable non-PV triggers. Table:

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