| Summary: | (1) Background: We hypothesized that female sex would have a differential impact on left atrial (LA) low-voltage areas (LVAs) according to CHA<sub>2</sub>DS<sub>2</sub>-VA scores. (2) Methods: This study included 553 patients who underwent radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). LVAs were defined as regions with bipolar peak-to-peak voltages of <0.5 mV. The proportion of LVAs was calculated by dividing the total LVA by the LA surface area. (3) Results: There was no sex-related difference in LA LVAs among patients with a CHA<sub>2</sub>DS<sub>2</sub>-VA scores ≤ 2. The proportion of LVAs was significantly higher in females among patients with CHA<sub>2</sub>DS<sub>2</sub>-VA scores of 3 or 4 (10.1 (4.7–15.1)% vs. 15.8 (9.2–32.1)%; <i>p</i> = 0.027). Female sex was significantly associated with extensive LVAs (LVA proportion ≥ 30%). Females had odd ratios of 27.82 (95% confidence interval (CI) 3.33–756.8, <i>p</i> = 0.01), and 1.53 (95% CI 0.81–2.83, <i>p</i> = 0.184) for extensive LAVs in patients with CHA<sub>2</sub>DS<sub>2</sub>-VA scores ≥ 3 and CHA<sub>2</sub>DS<sub>2</sub>-VA scores < 3, respectively. In the multiple regression model, female patients with a CHA<sub>2</sub>DS<sub>2</sub>-VA ≥3 were significantly associated with a higher proportion of LVAs (β = 8.52, <i>p</i> = 0.039). (4) Conclusions: Female sex was significantly associated with extensive LVAs, particularly when their CHA<sub>2</sub>DS<sub>2</sub>-VA scores were ≥3. This result suggests that female sex has a differential effect on the extent of LVAs based on the presence of additional risk factors.
|
|---|