Gender differences in symptoms and functional status in patients with atrial fibrillation undergoing catheter ablation.

Abstract

Catheter ablation improves symptoms and quality of life in patients with atrial fibrillation (AF); however, despite its benefit, women are less likely than men to undergo catheter ablation. Women with AF have been described to have more frequent and severe symptoms with a lower quality of life than men, and it is therefore unclear why women are less likely to undergo catheter ablation. We prospectively characterized gender differences in AF symptoms among men and women undergoing ablation at UNC using questionnaire data. Functional capacity was assessed with the Duke Activity Status Index (DASI) and quality of life was assessed with the Canadian Cardiovascular Society Symptoms of AF score (CCS-SAF) and the AF Effect on Quality-of-Life Questionnaire Tool (AFEQT). Among 191 patients in the study, women were less likely to undergo catheter ablation and had higher rates of paroxysmal AF and higher CHADS2 -VASc scores than men. Women had a worse functional capacity with significantly lower DASI scores than men; quality of life was also worse among women, with higher CCS-SAF scores and lower AFEQT scores than men. After adjustment for AF type, there was a persistent gender difference for functional capacity and symptom measures. At the time of catheter ablation, women with AF had a significantly lower functional status with worse symptoms and a lower quality of life than men. The role of this symptom difference on the gender gap in enrollment for catheter ablation is unclear and likely due to multiple patient and provider factors.