AI Article Synopsis
- - The study investigates why atrial fibrillation (AF) recurrence rates differ between sexes, focusing on the roles of non-pulmonary vein (PV) foci and epicardial adipose tissue (EAT).
- - Data from 304 patients revealed that females had more non-PV foci and less EAT around the atrium compared to males, with specific patterns observed in the left atrial wall.
- - Key predictors for AF recurrence included female sex, presence of non-PV foci, left atrial diameter, and septal EAT, with notable differences in predictors between males and females.
Article Abstract
Background: The mechanism underlying the sex differences in atrial fibrillation (AF) recurrence following pulmonary vein (PV) isolation is not fully understood. We hypothesized that non-PV foci and epicardial adipose tissue (EAT) play a key role.
Methods and results: Data from 304 consecutive patients (75% males) who underwent contrast-enhanced computed tomography and catheter ablation of AF were reviewed. The EAT around the atrium was measured separately in 4 parts of the atrium. All patients underwent high-dose isoproterenol infusions to assess the non-PV foci. Significantly more non-PV foci and less EAT around the atrium were observed in female patients than in male patients. In males, those with non-PV foci on the left atrial (LA) anterior wall had significantly greater EAT for the same lesions than those without non-PV foci. During a median follow-up of 27 months, the predictors of AF recurrence after first catheter ablation were female sex, presence of non-PV foci, LA diameter, and septal EAT index. A sex-specific analysis revealed that LA diameter was a predictor only in males and that the presence of non-PV foci in the septal region was a strong predictor in males (hazard ratio [HR]: 2.24) and females (HR: 3.65).
Conclusions: Sex-specific differences were observed in non-PV foci sites and local EAT and in regard to the predictors of AF recurrence.
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| http://dx.doi.org/10.1253/circj.CJ-22-0196 | DOI Listing |
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