Sex differences in complications of catheter ablation for atrial fibrillation: results on 85,977 patients

Claude S. Elayi, Yousef Darrat, John M. Suffredini, Naoki Misumida, Jignesh Shah, Gustavo Morales, William Wilson, Katrina Bidwell, Melissa Czarapata, Kevin Parrott, Luigi Di Biase, Andrea Natale, Gbolahan O. Ogunbayo

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8 Scopus citations

Abstract

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.

Original languageEnglish (US)
JournalJournal of Interventional Cardiac Electrophysiology
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

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Keywords

  • Adverse events
  • Atrial fibrillation
  • Catheter ablation
  • Complications
  • Sex
  • Women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Elayi, C. S., Darrat, Y., Suffredini, J. M., Misumida, N., Shah, J., Morales, G., Wilson, W., Bidwell, K., Czarapata, M., Parrott, K., Di Biase, L., Natale, A., & Ogunbayo, G. O. (Accepted/In press). Sex differences in complications of catheter ablation for atrial fibrillation: results on 85,977 patients. Journal of Interventional Cardiac Electrophysiology. https://doi.org/10.1007/s10840-018-0416-1