CLINICAL RESEARCH: ELECTROPHYSIOLOGIC DISORDERS
Significant gender-related differences in radiofrequency catheter ablation therapy
Nikolaos Dagres, MD* ,*,
Jonathan R. Clague, MD* ,
Günter Breithardt, MD, FACC* and
Martin Borggrefe, MD
* Department of Cardiology and Angiology, Hospital of the Westfaelische, Wilhelms-University and Institute for Arteriosclerosis Research, Muenster, Germany
Department of Cardiology, Angiology, and Pneumology of the University Hospital of Mannheim, Clinical Faculty of the University Heidelberg, Mannheim, Germany
Department of Cardiology, 401 General Army Hospital, Athens, Greece
Royal Brompton Hospital, London, United Kingdom
Manuscript received February 13, 2003;
revised manuscript received May 5, 2003,
accepted May 30, 2003.
* Reprint requests and correspondence: Dr. Nikolaos Dagres, 401 General Army Hospital, Department of Cardiology, Kanellopoulou 1, Mesogeion and Katehaki, 11525 Athens, Greece.
nikolaosdagres{at}yahoo.de
OBJECTIVES: We investigated possible differences between male and female patients regarding ablation therapy.
BACKGROUND: Gender-related differences might have a major impact on different aspects of radiofrequency ablation therapy. Data on this topic are very limited, focusing almost exclusively on success and recurrence rates.
METHODS: The study population consisted of 894 consecutive patients who underwent catheter ablation of accessory pathways (n = 519) and/or atrioventricular nodal re-entrant tachycardia (AVNRT) (n = 379). There were 418 (46.8%) male and 476 (53.2%) female patients.
RESULTS: Female patients were referred for ablation later than male patients (185 ± 143 vs. 157 ± 144 months after onset of symptoms, p < 0.001) and after having been given more antiarrhythmic drugs (1.6 ± 1.2 vs. 1.3 ± 1.1, p < 0.001). Women were more symptomatic, with a higher number of patients having >1 tachycardia episode per month (80.3% vs. 70.3% in men, p < 0.001). Fluoroscopy time, radiofrequency applications, and procedure duration were similar in male and female patients undergoing accessory pathway ablation as well as in male and female patients undergoing AVNRT ablation. No difference was seen in success, complication, and recurrence rates between men and women.
CONCLUSIONS: Physicians and/or patients tend toward a more conservative approach in female patients. Women are referred for ablation later than are men, after a longer duration of symptoms, and after having been given more antiarrhythmic drugs. However, potential concerns on behalf of physicians or female patients do not seem to be justified: ablation procedures in women had equally high success, low complication, and low recurrence rates as those procedures in male patients.
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Abbreviations and Acronyms
| | AV | | atrioventricular | | AVNRT | | atrioventricular nodal re-entrant tachycardia | | CABG | | coronary artery bypass grafting | | CAD | | coronary artery disease | | ECG | | electrocardiogram | | MI | | myocardial infarction |
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