Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-168 - Sex Differences In Ablation Strategy And Complications Of Catheter Ablation For Atrial Fibrillation: From The AHA Get With The Guidelines - Atrial Fibrillation (GWTG-AFIB) Registry (ID 1137)


Background: When presenting for atrial fibrillation (AF) ablation, women, compared to men, tend to have more non-pulmonary vein triggers and more advanced atrial disease. Whether this informs differences in AF ablation strategy is not well described.
Objective: We aimed to characterize ablation strategy by sex in current clinical practice using the Get With The Guidelines-AF (GWTG-AFIB) registry.
Methods: From the GWTG-AFIB registry ablation module, we included patients who underwent AF ablation between 01/2016 and 11/2018. We excluded patients who had previously undergone AF ablation and sites reporting <25 patients. Patients were stratified based on AF type (paroxysmal [PAF] vs. non-paroxysmal [NPAF]) and sex. We compared patient demographics, ablation strategy, and complications.
Results: Among 1,579 patients from 16 sites who underwent AF ablation, 589 were women (37.3%) and 990 were men (62.7%). Women referred for ablation, as compared to men, were older but less likely to have heart failure or prior myocardial infarction. In women with NPAF, as compared to men, left atrial linear ablation (i.e., roof and mitral lines) was more frequent. Complication rates were higher for women regardless of AF type (Table).
Conclusion: Women constitute 37% of the GWTG-AFIB registry ablation module and, for women with NPAF, are more likely to receive adjunctive lesion sets as compared to men. Increased complication risk for women undergoing AF ablation may be partially attributable to more aggressive ablation strategies.