Gender specific considerations in atrial fibrillation treatment: a review.

INTRODUCTION: Distinct differences in clinical presentation, utilization of therapy and outcome of atrial fibrillation (AF) management are observed in men vs women. This review focuses on our current knowledge on these sex-specific variations and how those impact the detection of AF and therapeutic decisions. AREAS COVERED: The current article reviews reports illustrating gender-related differences in the incidence, prevalence, clinical presentations, different risk factors, pathophysiology, therapeutic strategies, procedural parameters in catheter ablation for AF and complications and long-term outcome of ablative therapy including arrhythmia recurrence and quality of life. Some of these areas have been investigated widely providing conclusive evidences, whereas others have many unanswered questions or conflicting findings that need clarifications. EXPERT OPINION: Attainment of sinus rhythm and healthy quality of life as well as prevention of complications, especially stroke, are the main goals of AF management. Sex-specific variations are evident in many areas in the spectrum of AF that should be addressed by large population-based or randomized trials to facilitate customization of AF-therapy to maximize success in both genders.