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Gender differences in major vascular complications of catheter ablation for atrial fibrillation
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  • Jiří Plášek,
  • Dan Wichterle,
  • Petr Peichl,
  • Robert Čihák,
  • Patrik Jarkovský,
  • Tomáš Roubíček,
  • Predrag Stojadinović,
  • Jana Hašková,
  • Josef Kautzner
Jiří Plášek
Institut klinicke a experimentalni mediciny
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Dan Wichterle
General University Hospital
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Petr Peichl
IKEM
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Robert Čihák
Institut klinicke a experimentalni mediciny
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Patrik Jarkovský
Ústřední vojenská nemocnice - Vojenská fakultní nemocnice Praha
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Tomáš Roubíček
Krajská nemocnice Liberec as
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Predrag Stojadinović
Institut klinicke a experimentalni mediciny
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Jana Hašková
Institut klinicke a experimentalni mediciny
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Josef Kautzner
Institute for Clinical and Experimental Medicine
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Abstract

Aims: Catheter ablation (CA) for atrial fibrillation (AF) has a considerable risk of procedural complications. Major vascular complications (MVCs) appear to be the most frequent. This study investigated gender differences in MVCs in patients undergoing CA for AF. Methods: A total of 4734 CAs for AF (65% paroxysmal, 26% repeated procedures) were performed at our center between January 2006 and August 2018. Patients (71% males) aged 60 ± 10 years and had body mass index of 29 ± 4 kg/m2. Radiofrequency point-by-point ablation was employed in 96.3% procedures with the use of 3D navigation systems and facilitated by intracardiac echocardiography. Pulmonary vein isolation was mandatory; cavotricuspid isthmus and left atrial substrate ablation were performed in 22% and 38% procedures, respectively. MVCs were defined as those that resulted in permanent injury, required intervention, or prolonged hospitalization. Their rates and risk factors were compared between genders. Results: A total of 112 (2.4%) MVCs were detected: 54/1512 (3.5%) in females and 58/3222 (1.8%) in males (P < 0.0001). On multivariate analysis, lower body height was the only risk factor for MVCs in females (P = 0.0005). On the contrary, advanced age was associated with MVCs in males (P = 0.006). Conclusion: Females have a higher risk of MVCs following CA for AF compared to males. This difference is driven by lower body size in females. Low body height in females and advanced age in males are independent predictors of MVCs. US-guided venipuncture lowered the MVC rate in males.

Peer review status:ACCEPTED

25 Sep 2020Submitted to Journal of Cardiovascular Electrophysiology
25 Sep 2020Submission Checks Completed
25 Sep 2020Assigned to Editor
25 Sep 2020Reviewer(s) Assigned
17 Oct 2020Review(s) Completed, Editorial Evaluation Pending
18 Oct 2020Editorial Decision: Revise Minor
09 Nov 20201st Revision Received
16 Nov 2020Assigned to Editor
16 Nov 2020Submission Checks Completed
16 Nov 2020Reviewer(s) Assigned
10 Dec 2020Review(s) Completed, Editorial Evaluation Pending
14 Dec 2020Editorial Decision: Revise Minor
19 Dec 20202nd Revision Received
20 Dec 2020Submission Checks Completed
20 Dec 2020Assigned to Editor
20 Dec 2020Reviewer(s) Assigned
04 Jan 2021Review(s) Completed, Editorial Evaluation Pending
04 Jan 2021Editorial Decision: Accept