Sex Difference in Atrial Fibrillation Recurrence After Catheter Ablation.

Atrial fibrillation (AF) is a common sustained arrhythmia associated with increased risks of cardiovascular and renal diseases and adverse clinical outcomes, including mortality. Catheter ablation is an established method to restore sinus rhythm, but AF recurrence remains high. The impact of sex differences on recurrence after catheter ablation is poorly understood. This study investigated sex differences in AF recurrence using a propensity score matched cohort. A multiple imputation method, "Generates Multivariate Imputations by Chained Equations," addressed missing variables. Univariate Cox proportional hazards regression analysis identified variables significantly associated with AF recurrence (p < 0.05). Propensity score matching created a matched cohort with sex as the dependent variable and significant variables as independent variables. The study included 507 AF patients (143 females, 364 males), with 147 experiencing AF recurrence. Recurrence rates did not significantly differ between females and males (33.6% vs. 27.2%, p = 0.189). After 1:1 matching, 232 patients (116 females, 116 males) were included. AF recurrence was higher in females than males (33.6% vs. 12.9%, p < 0.001). The recurrence-free curves of females and males differed significantly (p < 0.001). Females had a higher risk of AF recurrence than males (hazard ratio: 2.70, 95% confidence interval: 1.49-4.90, p = 0.001).This study highlights the importance of considering sex disparities in AF management and treatment strategies to improve patient outcomes and personalize care.