Gender-Related Differences in Patients Who Underwent Catheter Ablation of Atrial Fibrillation

Background: Gender differences in atrial fibrillation (AF) have not been fully elucidated. Methods: This study enrolled 297 consecutive patients (women/men 74/223) with symptomatic AF who underwent AF ablation using NavX system. The gender differences in the clinical parameters, atrial substrate properties, and clinical outcome in this population were studied. Results: Women were older, lower incidence of non-paroxysmal AF, and higher incidence of pure pulmonary vein (PV) triggers than men. Although there was no significant gender difference in the incidence of non-PV triggers, women had a higher incidence of pure superior vena cava triggers than men. Regarding the atrial substrate properties during sinus rhythm, women had lower peak-to-peak voltages in the right atrium and higher dominant frequencies (DFs) in both atria. In contrast, according to the high density mapping during AF, men had a shorter mean CFE and higher mean DF value in the left atrium. Kaplan-Meier analysis demonstrated that the sinus rhythm maintenance rate after AF ablation was similar between women and men at a mean follow-up of 18 ± 7 months. However, in the patient group with non-PV triggers (N=35), men had a significantly higher AF recurrence than women (P<0.05). Conclusion: This study demonstrated the gender-related differences in the clinical features and atrial substrate properties in AF patients.