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Zhang R, Malkani KV, Gabriels JK, Reznik E, Li HA, Mandler AG, Qu V, Ip JE, Thomas G, Liu CF, Markowitz SM, Lerman BB, Cheung JW. Rates of pulmonary vein reconnection at repeat ablation for recurrent atrial fibrillation and its impact on outcomes among females and males. Pacing Clin Electrophysiol 2024; 47:869-877. [PMID: 38605573 DOI: 10.1111/pace.14984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Several studies have demonstrated that females have a higher risk of arrhythmia recurrence after pulmonary vein (PV) isolation for atrial fibrillation (AF). There are limited data on sex-based differences in PV reconnection rates at repeat ablation. We aimed to investigate sex-based differences in electrophysiological findings and atrial arrhythmia recurrence after repeat AF ablation METHODS: We conducted a retrospective study of 161 consecutive patients (32% female, age 65 ± 10 years) who underwent repeat AF ablation after index PV isolation between 2010 and 2022. Demographics, procedural characteristics and follow-up data were collected. Recurrent atrial tachycardia (AT)/AF was defined as any atrial arrhythmia ≥30 s in duration. RESULTS Compared to males, females tended to be older and had a significantly higher prevalence of prior valve surgery (10 vs. 2%; P = .03). At repeat ablation, PV reconnection was found in 119 (74%) patients. Males were more likely to have PV reconnection at repeat ablation compared to females (81 vs. 59%; P = .004). Excluding repeat PV isolation, there were no significant differences in adjunctive ablation strategies performed at repeat ablation between females and males. During follow-up, there were no significant differences in freedom from AT/AF recurrence between females and males after repeat ablation (63 vs. 59% at 2 years, respectively; P = .48). CONCLUSIONS After initial PV isolation, significantly fewer females have evidence of PV reconnection at the time of repeat ablation for recurrent AF. Despite this difference, long-term freedom from AT/AF was similar between females and males after repeat ablation.
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Affiliation(s)
- Ruina Zhang
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - Kabir V Malkani
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - James K Gabriels
- Department of Cardiology, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, New York, New York, USA
| | - Elizabeth Reznik
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - Han A Li
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - Ari G Mandler
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - Veronica Qu
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - James E Ip
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - George Thomas
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - Christopher F Liu
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - Steven M Markowitz
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - Bruce B Lerman
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
| | - Jim W Cheung
- Department of Medicine, Division of Cardiology Weill Cornell Medicine--New York Presbyterian Hospital, New York, New York, USA
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Reiffel JA. Selected Advances in the Anti-arrhythmic Management of Atrial Fibrillation: 2023. J Innov Card Rhythm Manag 2024; 15:5728-5734. [PMID: 38304092 PMCID: PMC10829416 DOI: 10.19102/icrm.2024.15014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
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