Josep M Alegret1, Xavier Viñolas2, Antoni Martínez-Rubio3, Alonso Pedrote4, Xulio Beiras5, Jesús F García-Sacristán6, Francisco Crespo-Mancebo7, Francisco Ruiz-Mateas8. 1. 1 Grup de Recerca Cardiovascular, Hospital Universitari de Sant Joan, IISPV, Universitat Rovira i Virgili , Reus, Spain . 2. 2 Hospital de la Sta. Creu i St. Pau , Barcelona, Spain . 3. 3 Hospital Universitari Parc Taulí , Sabadell, Spain . 4. 4 Hospital Universitario Virgen del Rocío , Sevilla, Spain . 5. 5 Complejo Hospitalario Universitario de Vigo , Vigo, Spain . 6. 6 Hospital General de Albacete , Albacete, Spain . 7. 7 Hospital Lucus Augusti , Lugo, Spain . 8. 8 Hospital Costa del Sol , Marbella, Spain .
Abstract
BACKGROUND: Current recommendations on the rhythm control strategy for treatment of atrial fibrillation (AF) are more restrictive than a decade ago. Gender may play a role in decisions on the management of AF, including application of electrical cardioversion. METHODS: We analyzed clinical characteristics by gender in patients participating in the observational survey about stable patients underlying cardioversion in Spain (CARDIOVERSE) study (n=915), a survey of the practice of electrical cardioversion in 67 Spanish hospitals. We compared these data with those from a previous survey of electrical cardioversion in Spain (REVERSE study) performed 8 years previously. RESULTS: Patients undergoing electrical cardioversion were mainly men (76%). This finding was observed in all age groups, independently of symptoms. Men were younger (62±10 years vs. 69±9 years; p<0.001), more frequently asymptomatic and had a lower prevalence of hypertension and a lower stroke risk. Among asymptomatic patients, the predominance of men was especially evident in older age groups (<65 years, men 76%, women 24%; ≥65 years, men 92%, women 8% (p<0.001). Compared with the REVERSE study, we observed a decrease in the percentage of women among patients undergoing electrical cardioversion (37% REVERSE vs. 24% CARDIOVERSE; p<0.001), mainly in older than 65 years. CONCLUSIONS: Our results support the hypothesis that gender is a determinant in decisions on the most appropriate strategy for managing AF. We observed a decrease in the percentage of women undergoing electrical cardioversion during the last decade, especially in older asymptomatic patients.
BACKGROUND: Current recommendations on the rhythm control strategy for treatment of atrial fibrillation (AF) are more restrictive than a decade ago. Gender may play a role in decisions on the management of AF, including application of electrical cardioversion. METHODS: We analyzed clinical characteristics by gender in patients participating in the observational survey about stable patients underlying cardioversion in Spain (CARDIOVERSE) study (n=915), a survey of the practice of electrical cardioversion in 67 Spanish hospitals. We compared these data with those from a previous survey of electrical cardioversion in Spain (REVERSE study) performed 8 years previously. RESULTS:Patients undergoing electrical cardioversion were mainly men (76%). This finding was observed in all age groups, independently of symptoms. Men were younger (62±10 years vs. 69±9 years; p<0.001), more frequently asymptomatic and had a lower prevalence of hypertension and a lower stroke risk. Among asymptomatic patients, the predominance of men was especially evident in older age groups (<65 years, men 76%, women 24%; ≥65 years, men 92%, women 8% (p<0.001). Compared with the REVERSE study, we observed a decrease in the percentage of women among patients undergoing electrical cardioversion (37% REVERSE vs. 24% CARDIOVERSE; p<0.001), mainly in older than 65 years. CONCLUSIONS: Our results support the hypothesis that gender is a determinant in decisions on the most appropriate strategy for managing AF. We observed a decrease in the percentage of women undergoing electrical cardioversion during the last decade, especially in older asymptomatic patients.
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