AUTHOR=Hermida Alexis , Burtin Jacqueline , Kubala Maciej , Fay Floriane , Lallemand Pierre-Marc , Buiciuc Otilia , Lieu Audrey , Zaitouni Mustafa , Beyls Christophe , Hermida Jean-Sylvain 

TITLE=Sex Differences in the Outcomes of Cryoablation for Atrial Fibrillation

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.893553

DOI=10.3389/fcvm.2022.893553

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>The literature data on the outcomes of radiofrequency catheter ablation for atrial fibrillation (AF) in women are contradictory.</p></sec><sec><title>Aim</title><p>To determine and compare the outcomes and complications of cryoballoon pulmonary vein isolation (cryo-PVI) in men vs. women, and to identify predictors of atrial tachyarrhythmia (ATa) recurrence.</p></sec><sec><title>Methods</title><p>We included all consecutive patients having undergone cryo-PVI for the treatment of symptomatic AF in our center since 2012. Peri-operative complications were documented. All patients were prospectively monitored for the recurrence of ATa, and predictors were assessed.</p></sec><sec><title>Results</title><p>A total of 733 patients were included (550 men (75%) and 183 (25%) women). Paroxysmal AF was recorded in 112 (61%) female patients and 252 male patients (46%; <italic>p</italic> &lt; 0.001). Female patients were older (<italic>p</italic> &lt; 0.001) and had a greater symptom burden (<italic>p</italic> = 0.04). Female patients were more likely to experience complications (<italic>p</italic> = 0.02). After cryo-PVI for paroxysmal AF, 66% of the female patients and 79% of the male patients were free of ATa at 24 months (<italic>p</italic> = 0.001). Female sex was the only independent predictive factor for ATa recurrence (hazard ratio [95% confidence interval] = 1.87 [1.28; 2.73]; <italic>p</italic> = 0.001). After cryo-PVI for non-paroxysmal AF, 37% of the male patients and 39% of the female patients were free of ATa at 36 months (<italic>p</italic> = 0.73). Female patients were less likely than male patients to undergo repeat ablation after an index cryo-PVI for non-paroxysmal AF (<italic>p</italic> = 0.019).</p></sec><sec><title>Conclusion</title><p>A single cryo-PVI procedure for paroxysmal AF was significantly less successful in female patients than in male patients. Overall, the complication rate was higher in women than in men.</p></sec>