PDF(Pubmed)
Abstract：
BACKGROUND: There is sufficient evidence that women with atrial fibrillation (AF) have a greater symptom burden than men with AF and are more likely to experience recurrence after catheter ablation. However, the mechanisms underlying these sex differences are unclear.
METHODS: We prospectively enrolled 125 consecutive patients, including 40 non-AF patients and 85 AF patients, who underwent high-density voltage mapping during sinus rhythm and AF patients who underwent first ablation.
RESULTS: Overall, 37 (44%) female patients with AF and 24 (60%) female non-AF patients with a mean age of 61.7 ± 11.6 years and 53.6 ± 16.7 years, respectively, were enrolled in this study. The results showed that the atrial voltage of female AF patients was significantly lower than that of male AF patients (1.11 ± 0.58 mV vs. 1.53 ± 0.65 mV; P = 0.003), while there were no significant sex differences in non-AF patients (3.02 ± 0.86 mV vs. 3.21 ± 0.84 mV; P = 0.498). Multiple linear regression analysis revealed that female sex (- 0.29, 95% confidence interval [CI] - 0.64 to - 0.13, P = 0.004) and AF type (- 0.32, 95% CI - 0.69 to - 0.13, P = 0.004) were the only factors independently associated with voltage. Compared with men, women in the paroxysmal AF group had a 3.5-fold greater incidence of recurrence (adjusted hazard ratio 4.49; 95% CI 1.101-18.332, P = 0.036). Both globally and regionally, the results showed that sex-related differences in voltage values occurred prominently in paroxysmal AF patients but not in nonparoxysmal AF patients.
CONCLUSIONS: Sex-related differences in atrial substrates and arrhythmia-free survival were found in paroxysmal AF patients, suggesting the existence of sex-related pathophysiological factors.
METHODS: We prospectively enrolled 125 consecutive patients, including 40 non-AF patients and 85 AF patients, who underwent high-density voltage mapping during sinus rhythm and AF patients who underwent first ablation.
RESULTS: Overall, 37 (44%) female patients with AF and 24 (60%) female non-AF patients with a mean age of 61.7 ± 11.6 years and 53.6 ± 16.7 years, respectively, were enrolled in this study. The results showed that the atrial voltage of female AF patients was significantly lower than that of male AF patients (1.11 ± 0.58 mV vs. 1.53 ± 0.65 mV; P = 0.003), while there were no significant sex differences in non-AF patients (3.02 ± 0.86 mV vs. 3.21 ± 0.84 mV; P = 0.498). Multiple linear regression analysis revealed that female sex (- 0.29, 95% confidence interval [CI] - 0.64 to - 0.13, P = 0.004) and AF type (- 0.32, 95% CI - 0.69 to - 0.13, P = 0.004) were the only factors independently associated with voltage. Compared with men, women in the paroxysmal AF group had a 3.5-fold greater incidence of recurrence (adjusted hazard ratio 4.49; 95% CI 1.101-18.332, P = 0.036). Both globally and regionally, the results showed that sex-related differences in voltage values occurred prominently in paroxysmal AF patients but not in nonparoxysmal AF patients.
CONCLUSIONS: Sex-related differences in atrial substrates and arrhythmia-free survival were found in paroxysmal AF patients, suggesting the existence of sex-related pathophysiological factors.
摘要：
背景：有足够的证据表明，房颤（AF）的女性比房颤的男性具有更大的症状负担，并且在导管消融后更有可能复发。然而,这些性别差异的潜在机制尚不清楚.
方法：我们前瞻性招募了125名连续患者，包括40例非房颤患者和85例房颤患者，在窦性心律期间接受高密度电压标测的房颤患者和首次接受消融的房颤患者。
结果：总体而言，37例（44%）女性房颤患者和24例（60%）女性非房颤患者，平均年龄为61.7±11.6岁和53.6±16.7岁，分别,参加了这项研究。结果表明,女性房颤患者的心房电压明显低于男性房颤患者(1.11±0.58mVvs.1.53±0.65mV;P=0.003),而非房颤患者无显著性别差异(3.02±0.86mVvs.3.21±0.84mV；P=0.498）。多元线性回归分析显示，女性性别（-0.29，95％置信区间[CI]-0.64至-0.13，P=0.004）和AF类型（-0.32，95％CI-0.69至-0.13，P=0.004）是唯一与电压独立相关的因素。和男人相比,阵发性房颤组女性的复发率高3.5倍(校正风险比4.49;95%CI1.101~18.332,P=0.036).无论是全球还是区域,结果显示,与性别相关的电压值差异在阵发性房颤患者中显著,但在非阵发性房颤患者中不显著.
结论：在阵发性房颤患者中发现了心房基质和无心律失常生存的性别相关差异，提示性别相关病理生理因素的存在。
方法：我们前瞻性招募了125名连续患者，包括40例非房颤患者和85例房颤患者，在窦性心律期间接受高密度电压标测的房颤患者和首次接受消融的房颤患者。
结果：总体而言，37例（44%）女性房颤患者和24例（60%）女性非房颤患者，平均年龄为61.7±11.6岁和53.6±16.7岁，分别,参加了这项研究。结果表明,女性房颤患者的心房电压明显低于男性房颤患者(1.11±0.58mVvs.1.53±0.65mV;P=0.003),而非房颤患者无显著性别差异(3.02±0.86mVvs.3.21±0.84mV；P=0.498）。多元线性回归分析显示，女性性别（-0.29，95％置信区间[CI]-0.64至-0.13，P=0.004）和AF类型（-0.32，95％CI-0.69至-0.13，P=0.004）是唯一与电压独立相关的因素。和男人相比,阵发性房颤组女性的复发率高3.5倍(校正风险比4.49;95%CI1.101~18.332,P=0.036).无论是全球还是区域,结果显示,与性别相关的电压值差异在阵发性房颤患者中显著,但在非阵发性房颤患者中不显著.
结论：在阵发性房颤患者中发现了心房基质和无心律失常生存的性别相关差异，提示性别相关病理生理因素的存在。
