論文

国際誌
2020年9月1日

Sex differences in atrial fibrillation ablation outcomes: insights from a large-scale multicentre registry.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
  • Nobuaki Tanaka
  • Koichi Inoue
  • Atsushi Kobori
  • Kazuaki Kaitani
  • Takeshi Morimoto
  • Toshiya Kurotobi
  • Itsuro Morishima
  • Hirosuke Yamaji
  • Yumie Matsui
  • Yuko Nakazawa
  • Kengo Kusano
  • Masato Okada
  • Koji Tanaka
  • Yuko Hirao
  • Takafumi Oka
  • Yasushi Koyama
  • Atsunori Okamura
  • Katsuomi Iwakura
  • Kenshi Fujii
  • Takeshi Kimura
  • Satoshi Shizuta
  • 全て表示

22
9
開始ページ
1345
終了ページ
1357
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1093/europace/euaa104

AIM: The impact of sex differences on the clinical outcomes of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) is controversial. We investigated the sex differences regarding the efficacy and clinical outcomes of RFCA of AF. METHODS AND RESULTS: We conducted a large-scale, prospective, multicentre, observational study (Kansai Plus Atrial Fibrillation Registry). We enrolled 5010 consecutive patients who underwent an initial RFCA of AF at 26 centres (64 ± 10 years; non-paroxysmal AF, 35.7%). The median follow-up duration was 2.9 years. Female patients (n = 1369, 27.3%) were older (female vs. male, 68 ± 9 vs. 63 ± 11 years, P < 0.0001) with a lower prevalence of non-paroxysmal AF (27.1% vs. 38.9%, P < 0.0001). Fewer females experienced time-dependent pulmonary vein (PV) reconnections and more females received a non-PV foci ablation than males in the index RFCA. The 3-year cumulative incidence of AF recurrences in the multivariate analysis after single procedures was significantly higher in females than males (43.3% vs. 39.0%, log rank P = 0.0046). Females remained an independent predictor of AF recurrence (hazard ratio 1.24; 95% confidence interval 1.12-1.38, P < 0.0001). The AF recurrence rates after multiple procedures were also higher in females, but fewer females experienced PV reconnections during second sessions. More females experienced de novo pacemaker implantations during the long-term follow-up. Females were associated with a higher risk of heart failure hospitalizations and major bleeding after RFCA in the multivariate analysis. CONCLUSIONS: Females experienced more frequent AF recurrences probably due to non-PV arrhythmogenicity and de novo pacemaker implantations than males during the long-term follow-up after RFCA of AF.

リンク情報
DOI
https://doi.org/10.1093/europace/euaa104
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32548641
ID情報
  • DOI : 10.1093/europace/euaa104
  • PubMed ID : 32548641

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