Clinical outcomes after pulmonary vein isolation for atrial fibrillation in men versus women; insights from a contemporary large-scale population study

Abstract Funding Acknowledgements Type of funding sources: None. Background Atrial fibrillation (AF) is associated with an increased risk stroke and mortality. Pulmonary vein isolation (PVI) the most effective treatment to reduce AF burden a reduced death. Differences in long-term clinical outcomes following PVI between sexes are debatable. Purpose We aimed explore sex differences contemporary population patients. Methods This historical population-based study including all adult patients largest health maintenance organization Israel who were first diagnosed January 1st, 2010, 2020. Patients congenital heart disease, significant mitral stenosis, or underwent valvular surgery excluded. The primary all-cause death after PVI. Early (30-day) compared using logistic regression, late (3-year) assessed multivariable survival analyses Cox regression. Results Of 94,612 incident during period, 4593 (4.85%) PVI, whom 1892 (38.2%) women. Women older (65±12 vs. 63±13) less likely be smokers (15.0% 33.0%). had higher body-mass-index (30.26±6.58 29.14±4.86) rates hypertension (66.4% 63.2%) but lower known coronary peripheral vascular disease congestive failure (p<0.05 for all). CHA2DS2-VASc score was among women men [median 3 (IQR 2-4) median 2 IQR (1-3), p<0.001). Compared men, treated more often beta-blockers (74.5% 69.4%), non-dihydropyridine calcium channel blockers (6.5% 3.0%), class 1c antiarrhythmic drugs (19.4% 12.8%; p<0.001 all), amiodarone (14.2% 18.1%, In 30 days CA, occurred 8 (0.2%) patients, 26 (0.6%) died (p>0.1 both). Three-year mortality than (6.2%% 8.6%, p=0.003), while similar (1.0%) (1.5%, p>0.1). models, adjusting potential confounders, [aHR 0.72 95%CI (0.56-0.92), p=0.009]. Conversely, 0.62 (0.33-1.12), p=0.114]. results propensity-adjusted models accounting Conclusions this population, short-term very low relatively across criteria. despite undergoing procedure at age comorbidities background medical therapy, suggesting possible