B-PO05-074 SEX DIFFERENCES IN ATRIAL FIBRILLATION ABLATION OUTCOMES: A THREE YEAR RETROSPECTIVE SINGLE CENTER STUDY

Abstract

The impact of sex differences on the outcomes of catheter ablation (CA) of AF is controversial. Moreover, data are still lacking for persistent AF, due to women under-representation in this category. To investigate gender differences in the outcome of CA of AF. We performed a retrospective observational study of pts referred for first AF ablation between 2017-2019. All pts underwent pulmonary vein (PV) isolation with either radiofrequency or cryo-energy. Two groups were identified according to the sex. The primary outcome was AF recurrence-free survival. A total of 1102 pts was enrolled: 287 (26%) female. The two groups were balanced for baseline characteristics (age, type of AF, BMI, left atrial volume, and CHA2DS2-VASC). Pts with persistent AF were 38% (309). The primary outcome was seen in 76% (77) of men and 70% (175) of woman (p=0,029). When stratified according to AF sub-type, 73% (55) of patients with paroxysmal AF in the female group were free of AF versus 79% (106) of patients in the male group (p=0.068). In the late persistent AF group, only 38% of the women and 61% of the men were free of AF (p=0,014). At multivariate analysis female sex was an independent predictor of arrhythmia recurrences (p=0,035). Time from symptoms occurrence to diagnosis was significantly longer in female: 5,4 mm (SD 24.8) vs 2,5 mm (SD 21.3) (p=0004). Female gender is independently and strongly associated with a worse outcome in pts referred to CA of AF, especially in persistent cases. A longer time from symptoms to diagnosis may partially explain these results. Further studies are required to investigate the role of a more advanced disease stage or Non PV triggers in women.