Assessment of sex-related differences and outcome in patients who underwent cryoballoon pulmonary vein isolation for atrial fibrillation: an observational cohort study
Objectives Pulmonary vein isolation (PVI) is widely accepted as an effective and safe treatment for symptomatic atrial fibrillation (AF). However, data on sex-related differences and associations with clinical outcome and safety of PVI with cryoballoon ablation are limited. We sought to compare sexr...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/11/e063359.full |
| _version_ | 1811180249142001664 |
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| author | Michiel Rienstra Robert G Tieleman Isabelle C van Gelder Bart A Mulder Yuri Blaauw Eng S Tan Federico T Magni Hessel F Groenveld Neda Khalilian Ekrami Vijay Dayalani Ans CP Wiesfeld |
| author_facet | Michiel Rienstra Robert G Tieleman Isabelle C van Gelder Bart A Mulder Yuri Blaauw Eng S Tan Federico T Magni Hessel F Groenveld Neda Khalilian Ekrami Vijay Dayalani Ans CP Wiesfeld |
| author_sort | Michiel Rienstra |
| collection | DOAJ |
| description | Objectives Pulmonary vein isolation (PVI) is widely accepted as an effective and safe treatment for symptomatic atrial fibrillation (AF). However, data on sex-related differences and associations with clinical outcome and safety of PVI with cryoballoon ablation are limited. We sought to compare sexrelated efficacy and safety of cryoballoon ablation and identify sex-related associations with clinical outcomes.Methods and results We included 650 consecutive patients with AF undergoing PVI with cryoballoon ablation at our institution between 2013 and 2017. The efficacy outcome was the first documented recurrence (>30 s) of AF, atrial flutter or atrial tachycardia (AF/AT) or repeat ablation during follow-up, after a 90-day blanking period. The safety outcome was the incidence of periprocedural complications. Mean age of the population was 58±10, and 210 (32.3%) patients were women. Women were older, had a higher body mass index, had more renal dysfunction and less coronary artery disease as compared with men. The rate of AF/AT recurrence was similar between women and men at 12-month follow-up (27.6% vs 24.8%, p=0.445). The incidence of periprocedural complications was higher in women (12.9% vs 4.6%; p<0.001), specifically groin haematomas and phrenic nerve palsy. On multivariate analysis, left atrial volume index (adjusted OR 1.05, 95% CI 1.00 to 1.10; p=0.032) was associated with the incidence of procedural complications in women. For men, no relation with complications could be found.Conclusion The efficacy of cryoballoon ablation was similar between women and men; however, women had a higher risk of procedural complications. |
| first_indexed | 2024-04-11T06:48:09Z |
| format | Article |
| id | doaj.art-9a2d71bec5b0462b8446c07d68321861 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-11T06:48:09Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-9a2d71bec5b0462b8446c07d683218612022-12-22T04:39:18ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-063359Assessment of sex-related differences and outcome in patients who underwent cryoballoon pulmonary vein isolation for atrial fibrillation: an observational cohort studyMichiel Rienstra0Robert G Tieleman1Isabelle C van Gelder2Bart A Mulder3Yuri Blaauw4Eng S Tan5Federico T Magni6Hessel F Groenveld7Neda Khalilian Ekrami8Vijay Dayalani9Ans CP Wiesfeld10Department of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsDepartment of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsDepartment of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsDepartment of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsDepartment of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsDepartment of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsDepartment of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsDepartment of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsDepartment of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsDepartment of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsDepartment of Cardiology, Univeristy Medical Center Groningen, Groningen, The NetherlandsObjectives Pulmonary vein isolation (PVI) is widely accepted as an effective and safe treatment for symptomatic atrial fibrillation (AF). However, data on sex-related differences and associations with clinical outcome and safety of PVI with cryoballoon ablation are limited. We sought to compare sexrelated efficacy and safety of cryoballoon ablation and identify sex-related associations with clinical outcomes.Methods and results We included 650 consecutive patients with AF undergoing PVI with cryoballoon ablation at our institution between 2013 and 2017. The efficacy outcome was the first documented recurrence (>30 s) of AF, atrial flutter or atrial tachycardia (AF/AT) or repeat ablation during follow-up, after a 90-day blanking period. The safety outcome was the incidence of periprocedural complications. Mean age of the population was 58±10, and 210 (32.3%) patients were women. Women were older, had a higher body mass index, had more renal dysfunction and less coronary artery disease as compared with men. The rate of AF/AT recurrence was similar between women and men at 12-month follow-up (27.6% vs 24.8%, p=0.445). The incidence of periprocedural complications was higher in women (12.9% vs 4.6%; p<0.001), specifically groin haematomas and phrenic nerve palsy. On multivariate analysis, left atrial volume index (adjusted OR 1.05, 95% CI 1.00 to 1.10; p=0.032) was associated with the incidence of procedural complications in women. For men, no relation with complications could be found.Conclusion The efficacy of cryoballoon ablation was similar between women and men; however, women had a higher risk of procedural complications.https://bmjopen.bmj.com/content/12/11/e063359.full |
| spellingShingle | Michiel Rienstra Robert G Tieleman Isabelle C van Gelder Bart A Mulder Yuri Blaauw Eng S Tan Federico T Magni Hessel F Groenveld Neda Khalilian Ekrami Vijay Dayalani Ans CP Wiesfeld Assessment of sex-related differences and outcome in patients who underwent cryoballoon pulmonary vein isolation for atrial fibrillation: an observational cohort study BMJ Open |
| title | Assessment of sex-related differences and outcome in patients who underwent cryoballoon pulmonary vein isolation for atrial fibrillation: an observational cohort study |
| title_full | Assessment of sex-related differences and outcome in patients who underwent cryoballoon pulmonary vein isolation for atrial fibrillation: an observational cohort study |
| title_fullStr | Assessment of sex-related differences and outcome in patients who underwent cryoballoon pulmonary vein isolation for atrial fibrillation: an observational cohort study |
| title_full_unstemmed | Assessment of sex-related differences and outcome in patients who underwent cryoballoon pulmonary vein isolation for atrial fibrillation: an observational cohort study |
| title_short | Assessment of sex-related differences and outcome in patients who underwent cryoballoon pulmonary vein isolation for atrial fibrillation: an observational cohort study |
| title_sort | assessment of sex related differences and outcome in patients who underwent cryoballoon pulmonary vein isolation for atrial fibrillation an observational cohort study |
| url | https://bmjopen.bmj.com/content/12/11/e063359.full |
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