2025 Volume 66 Issue 4 Pages 562-569
Catheter ablation for atrial fibrillation (AF) is now a commonly performed procedure with improved techniques. Several studies have evaluated sex differences in AF, including efficacy and safety of catheter ablation, with inconsistent findings.
We compared the characteristics, success rate, and complications of catheter ablation in patients with AF focusing on sex differences. A total of 368 consecutive AF patients (men 254, women 114) who underwent catheter ablation from January 2017 to March 2022 at our institution were analyzed. Effects of catheter ablation on cardiac function in the left ventricle (LV) and left atrium (LA), and plasma B-type natriuretic peptide levels were evaluated at baseline and at 1-year follow-up.
Women underwent catheter ablation at an older age and with a lower body mass index (BMI) than men, but the recurrence rate at 1 year showed no significant difference. Among patients with paroxysmal AF (PAF), procedural complications occurred more often in women than in men after radiofrequency catheter ablation, but not after cryoballoon ablation. At 1 year after ablation, the LV ejection fraction, LA volume index, and LA emptying fraction were improved in women as well as in men, particularly in non-PAF patients.
Our findings indicate that catheter ablation for AF is effective in women, similar to men, particularly in terms of LA structure and function, despite being performed at an older age and in non-PAF patients. Additionally, cryoballoon ablation may be a suitable alternative to radiofrequency ablation in women with PAF.
