login
  Password reminder
Cardiac Rhythm News
Contact the editor Visit Cardiac Rhythm News Twitter feed Visit Cardiac Rhythm News Facebook page
 

Gender does not affect periprocedural complications or long-term results of catheter ablation


Wednesday, 05 Oct 2011 10:50
Sonia Ammar
Sonia Ammar


A study presented at the European Heart Rhythm Association (EHRA)-Europace conference (26–29 June, Madrid) shows that gender does not affect periprocedural complications or outcomes of catheter ablation for paroxysmal atrial fibrillation.

 


Investigators Ammar et al found that there was no significant differences between men and women in the incidence of periprocedural stroke and transient ischaemic attack (1.8 vs. 0.9%; p=0.35), tamponade (3.6 vs. 1.5%; p=0.12), severe haematoma (1.8 vs. 0.9%; p=0.3), pseudoaneurysm (0.6 vs. 0.6%; p=ns) or pulmonary vein stenosis (0.6 vs. 0.3; p=ns). Additionally, after a mean follow-up of 3.4±2.7 years, 51% of women and 55% of men were free from atrial arrhythmias without antiarrhythmic drugs (p=0.34).

 

The results of the new study are in contrast to previous studies, which have shown that women have more frequently persistent atrial fibrillation, complications and procedural failures than men. However, the lead investigator of the new study, Sonia Ammar, German Heart Center, Hospital rechts der Isar at the Technical University of Munich, said that her study may have had a more homogeneous population than had previous studies (which possibly explained why no differences in outcomes were observed between men and women). She explained that in her study, the duration of atrial fibrillation before ablation was about six years in both men and women and, unlike other studies, women were not referred later for catheter ablation despite being significantly older than men (61±9 years vs. 55±10 years). “In regard to acute complications, there was a tendency toward more tamponades in women without a statistical difference. It is important to say that we reported our experience [of catheter ablation] since 1998. In the early years, complications of catheter ablation for atrial fibrillation were more frequent. In the last few years, we had an incidence of tamponades of less than 1% in paroxysmal atrial fibrillation ablation. Therefore, the difference is disappearing.” According to Ammar, some specificities of the German population in the study may also have affected the result.

 

The women in her study, as well as being older, had a higher CHADS2 (Congestive heart failure, hypertension, age ≥75 years, and prior stroke) score but this baseline characteristic did not appear to significantly increase the incidence of stroke in women compared with men (2.4% vs. 3.5%). “Eighty seven per cent of strokes occurred in patients with atrial fibrillation recurrence and/or no adequate oral anticoagulation. Atrial fibrillation ablation seems to modify the course of the disease and the rate of stroke, particularly in women.”

 

Although gender does not appear to have a significant effect, according to this study at least, on the outcome of catheter ablation, it does significantly influence the pathophysiology, epidemiology, and clinical presentation of many cardiac arrhythmias. Ammar said: “Women have significantly longer QT intervals than men, despite having higher heart rates. In contrast, men have a higher incidence of atrial fibrillation, Brugada syndrome, early repolarisation syndrome and sudden death compared with women.” Additionally, as women have a greater risk of drug-induced QT prolongation, antiarrhythmic drugs have to be “prescribed very carefully” in women. Ammar concluded: “Differences in gender hormones may explain some of these findings, but the reasons for these gender differences are not completely understood.” 




Add New Comment

Related Items


Most popular


Thursday, 26 Feb 2015
Vitaria delivers autonomic regulation therapy for patients who have moderate to severe heart failure with left ventricular dysfunction (ejection fraction < 40%), and who remain symptomatic despite ... Vitaria vagal nerve stimulation system receives CE mark for treatment of chronic heart failure

Baroreflex neuromodulation therapy shows positive outcomes in heart failure treatment
Monday, 23 Mar 2015
The first randomised controlled trial studying carotid baroreflex stimulation for heart failure treatment has shown the therapy is safe and has demonstrated improvement in functional status, quality ... Baroreflex neuromodulation therapy shows positive outcomes in heart failure treatment

Boston Scientific receives FDA approval for Watchman left atrial appendage closure device
Monday, 16 Mar 2015
The device offers an alternative to long-term warfarin therapy for stroke risk reduction in patients with non-valvular atrial fibrillation. Boston Scientific receives FDA approval for Watchman left atrial appendage closure device

Features


SERVE-HF could be a wake-up call for cardiologists about central sleep apnoea
Tuesday, 24 Mar 2015
Martin Cowie (Imperial College London, London, UK) is the principal investigator of the SERVE-HF study, which is assessing the use of adaptive servo-ventilation (PaceWave, ResMed) in chronic heart ... SERVE-HF could be a wake-up call for cardiologists about central sleep apnoea

A new study explores heart failure treatment with vagal nerve stimulation
Thursday, 12 Mar 2015
Albert Hagège (Georges Pompidou European Hospital in Paris, France), principal investigator of Vanguard, a new study exploring the safety and efficacy of vagal nerve stimulation in heart failure ... A new study explores heart failure treatment with vagal nerve stimulation

Profiles


Hung-Fat Tse
Tuesday, 03 Feb 2015
While Hung-Fat Tse’s initial research interests focused on device therapy for cardiac arrhythmias, ... Hung-Fat Tse

Massimo Santini
Friday, 10 Oct 2014
Massimo Santini performed the first fulguration of the atrioventricular node of resistant ... Massimo Santini

Cardiac Rhythm News Vascular News Cardiovascular News Interventional News Spinal News NeuroNews
BIBA Medical BIBA MedTech Insights CX Symposium ilegx
 
Password Reminder

BIBA Medical, 526 Fulham Road, Fulham, London, SW6 5NR.
TEL: +44 (0)20 7736 8788 FAX: +44 (0)20 7736 8283 EMAIL: 
info@bibamedical.com
© BIBA Medical Ltd is a company registered in England and Wales with company number 2944429.
VAT registration number 730 6811 50.
Site Map | Terms and Conditions