New study uncovers gender disparity in ablation treatment and outcomes for AF


New multicentre research reveals that female patients fail ablation procedures more often than male patients, according to a study published in the February edition of the HeartRhythm Journal, the official journal of the Heat Rhythm Society. The study also shows that males undergo catheter ablation for the treatment of atrial fibrillation five times as often as females and typically with significantly fewer complications.

The multicentre study, which evaluated 3,265 patients between January 2005 and May 2008, collected patient data for women who underwent pulmonary vein antrum isolation, a form of catheter ablation. The research was initiated due to the paucity of information for such procedures among women. Previous studies also have reported gender disparities in the use of certain cardiovascular technologies – such as implantable cardioverter-defibrillator implantation, coronary artery bypass graft surgery, and cardiovascular diagnostic testing.

Researchers found that female patients failed ablation procedures at a higher rate than males (31.5% vs. 22.5%), and also incurred uncomfortable complications at nearly double the rate in some instances. When compared to male patients who underwent the same procedure, the research indicates females have a higher rate of non paroxysmal AF and extra pulmonary veins firing. In addition females had a higher incidence of bleeding complications, haematomas and pseudoaneurysms.

“Most atrial fibrillation studies have consisted predominately of male patients, and, accordingly, there is a real lack of information about the safety and efficacy of catheter ablation for females,” said Andrea Natale, executive medical director of the Texas Cardiac Arrhythmia Institute at St David’s Medical Center in Austin, USA. “The work ahead is to pinpoint why female patients are more likely to delay this procedure and to work with doctors to develop a better patient dialogue and treatment strategy.”

One possibility researchers say could explain the disparity is the age at which female patients undergo invasive treatment for atrial fibrillation. In the study, females referred for ablation tended to be older and had failed more antiarrhythmic agents, suggesting an apprehension toward catheter ablation. Experts involved in the study believe success rates for female patients may improve if ablation is performed earlier in treatment, an intervention that may be helped along by greater understanding of women’s heart health needs in the medical community.