TY - JOUR
T1 - Sex differences in complications of catheter ablation for atrial fibrillation
T2 - results on 85,977 patients
AU - Elayi, Claude S.
AU - Darrat, Yousef
AU - Suffredini, John M.
AU - Misumida, Naoki
AU - Shah, Jignesh
AU - Morales, Gustavo
AU - Wilson, William
AU - Bidwell, Katrina
AU - Czarapata, Melissa
AU - Parrott, Kevin
AU - Di Biase, Luigi
AU - Natale, Andrea
AU - Ogunbayo, Gbolahan O.
N1 - Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Purpose: Catheter ablation (CA) is an effective treatment for atrial fibrillation (AF). The differences in complication rates and outcomes between women and men remain poorly studied. We aimed to study the sex differences in morbidity and mortality associated with CA in AF. Methods: Using weighted sampling from the National Inpatient Sample database, women and men with a primary diagnosis of AF and a primary procedure of CA (2004–2013) were identified. We compared the following outcomes based on the sex: (1) major complications [post-procedure transfusion, cardiac drain or surgery, pulmonary embolism, cerebrovascular accident, major cardiac events, kidney failure requiring dialysis, and sepsis], (2) overall complications (minor and/or major complications), and (3) in-hospital mortality. Results: Among 85,977 patients who underwent CA for AF, 27821 (32.4%) were women. Overall complications were more frequent among women versus among men (12.4% versus 9.0%; p < 0.001), as well as major complications (4.7% versus 2.7%; p < 0.001). However, there was no difference in mortality (0.3% versus 0.2%; p = 0.22). After adjusting for other factors, women were more likely than men to have major complication (odds ratio 1.48, 95% CI 1.21–1.82; p < 0.001). Prior CABG was associated with lower risk of major complications in both sexes (odds ratio in the overall cohort 0.27, 95% CI 0.12–0.61; p = 0.002), mostly driven by the reduction in tamponade and pericardial drain. Conclusions: Among patients who underwent catheter ablation for AF, the female sex was associated with higher rate of complications compared to male but no difference in mortality. Prior CABG was associated with a significant reduction of major complications in both sexes.
AB - Purpose: Catheter ablation (CA) is an effective treatment for atrial fibrillation (AF). The differences in complication rates and outcomes between women and men remain poorly studied. We aimed to study the sex differences in morbidity and mortality associated with CA in AF. Methods: Using weighted sampling from the National Inpatient Sample database, women and men with a primary diagnosis of AF and a primary procedure of CA (2004–2013) were identified. We compared the following outcomes based on the sex: (1) major complications [post-procedure transfusion, cardiac drain or surgery, pulmonary embolism, cerebrovascular accident, major cardiac events, kidney failure requiring dialysis, and sepsis], (2) overall complications (minor and/or major complications), and (3) in-hospital mortality. Results: Among 85,977 patients who underwent CA for AF, 27821 (32.4%) were women. Overall complications were more frequent among women versus among men (12.4% versus 9.0%; p < 0.001), as well as major complications (4.7% versus 2.7%; p < 0.001). However, there was no difference in mortality (0.3% versus 0.2%; p = 0.22). After adjusting for other factors, women were more likely than men to have major complication (odds ratio 1.48, 95% CI 1.21–1.82; p < 0.001). Prior CABG was associated with lower risk of major complications in both sexes (odds ratio in the overall cohort 0.27, 95% CI 0.12–0.61; p = 0.002), mostly driven by the reduction in tamponade and pericardial drain. Conclusions: Among patients who underwent catheter ablation for AF, the female sex was associated with higher rate of complications compared to male but no difference in mortality. Prior CABG was associated with a significant reduction of major complications in both sexes.
KW - Adverse events
KW - Atrial fibrillation
KW - Catheter ablation
KW - Complications
KW - Sex
KW - Women
UR - http://www.scopus.com/inward/record.url?scp=85050959075&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050959075&partnerID=8YFLogxK
U2 - 10.1007/s10840-018-0416-1
DO - 10.1007/s10840-018-0416-1
M3 - Article
C2 - 30062452
AN - SCOPUS:85050959075
SN - 1383-875X
VL - 53
SP - 333
EP - 339
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
IS - 3
ER -