Linh Ngo1,2,3, Anna Ali4, Anand Ganesan5,6, Richard Woodman7, Robert Adams6,8, Isuru Ranasinghe1,2. 1. The Northside Clinical Unit, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, 4032, QLD, Australia. 2. Department of Cardiology, The Prince Charles Hospital, Brisbane, 4032, QLD, Australia. 3. Department of Cardiovascular and Thoracic Surgery, Cardiovascular Centre, E Hospital, Hanoi, 1000, Vietnam. 4. School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, 5000, SA, Australia. 5. Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, 5042, SA, Australia. 6. College of Medicine and Public Health, Flinders University, Adelaide, 5042, SA, Australia. 7. Flinders Centre for Epidemiology and Biostatistics, College of Medicine and Public Health, Flinders University, Adelaide, 5042, SA, Australia. 8. Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, 5042, SA, Australia.
Abstract
AIMS: Population studies that provide unbiased estimates of gender differences in risk of complications following catheter ablation of atrial fibrillation (AF) are sparse. We sought to evaluate the association of female gender and risk of complications following AF ablation in a nationwide cohort. METHODS AND RESULTS: We identified 35 211 patients (29.5% females) undergoing AF ablations from 2008 to 2017 using national hospitalization data from Australia and New Zealand. The primary outcome was any procedural complication occurring up to 30-days after discharge. Logistic regression was used to adjust for differences in baseline characteristics between sexes. Compared with males, females were older (mean age 64.9 vs. 61.2 years), had higher rates of hypertension (14.0% vs. 11.6%) and haematological disorders (5.3% vs. 3.8%) and experienced a higher rate of procedural complications (6.96% vs. 5.41%) (all P < 0.001). This gender disparity remained significant after adjustment [odds ratio (OR) 1.25 (95% confidence interval 1.14-1.38), P < 0.001] and was driven by an increased risk of vascular injury [OR 1.86 (1.23-2.82), P = 0.003], pericarditis [OR 1.86 (1.16-2.67), P = 0.008], pericardial effusion [OR 1.71 (1.35-2.17), P < 0.001), and bleeding [OR 1.30 (1.15-1.46), P < 0.001]. Notably, the gender difference persisted over time [OR for the most recent period 1.19 (1.003-1.422), P = 0.046] despite a declining complication rate in both men and women. CONCLUSION: Females undergoing AF ablations experienced a 25% higher risk of procedural complications compared with males, a disparity that has persisted over time despite a falling complication rate. Efforts to reduce this gender disparity should focus on reducing the incidence of pericardial effusion, pericarditis, vascular injury, and bleeding. Published on behalf of the European Society of Cardiology.
AIMS: Population studies that provide unbiased estimates of gender differences in risk of complications following catheter ablation of atrial fibrillation (AF) are sparse. We sought to evaluate the association of female gender and risk of complications following AF ablation in a nationwide cohort. METHODS AND RESULTS: We identified 35 211 patients (29.5% females) undergoing AF ablations from 2008 to 2017 using national hospitalization data from Australia and New Zealand. The primary outcome was any procedural complication occurring up to 30-days after discharge. Logistic regression was used to adjust for differences in baseline characteristics between sexes. Compared with males, females were older (mean age 64.9 vs. 61.2 years), had higher rates of hypertension (14.0% vs. 11.6%) and haematological disorders (5.3% vs. 3.8%) and experienced a higher rate of procedural complications (6.96% vs. 5.41%) (all P < 0.001). This gender disparity remained significant after adjustment [odds ratio (OR) 1.25 (95% confidence interval 1.14-1.38), P < 0.001] and was driven by an increased risk of vascular injury [OR 1.86 (1.23-2.82), P = 0.003], pericarditis [OR 1.86 (1.16-2.67), P = 0.008], pericardial effusion [OR 1.71 (1.35-2.17), P < 0.001), and bleeding [OR 1.30 (1.15-1.46), P < 0.001]. Notably, the gender difference persisted over time [OR for the most recent period 1.19 (1.003-1.422), P = 0.046] despite a declining complication rate in both men and women. CONCLUSION: Females undergoing AF ablations experienced a 25% higher risk of procedural complications compared with males, a disparity that has persisted over time despite a falling complication rate. Efforts to reduce this gender disparity should focus on reducing the incidence of pericardial effusion, pericarditis, vascular injury, and bleeding. Published on behalf of the European Society of Cardiology.
Authors: Sofia E Gomez; Muhammad Fazal; Julio C Nunes; Shayena Shah; Alexander C Perino; Sanjiv M Narayan; Kamala P Tamirisa; Janet K Han; Fatima Rodriguez; Tina Baykaner Journal: J Interv Card Electrophysiol Date: 2022-10-13 Impact factor: 1.759
Authors: Haran Yogasundaram; Sunjidatul Islam; Douglas C Dover; Nathaniel M Hawkins; Justin Ezekowitz; Padma Kaul; Roopinder K Sandhu Journal: CJC Open Date: 2022-05-06