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Sex differences in ventricular arrhythmia, atrial fibrillation and atrioventricular block complicating acute

Hilmi Alnsasra1,2, Gal Tsaban1,2, Jean Marc Weinstein1,2

  • 1Department of Cardiology, Soroka University Medical Center, Beersheva, Israel.

Frontiers in Cardiovascular Medicine
|November 6, 2023
PubMed

Insights

Women with acute myocardial infarction (AMI) experienced more atrial fibrillation (AF) and high-grade atrioventricular block (HAVB) but fewer early ventricular tachyarrhythmias (VTAs) than men. Both early and late VTAs, AF, and HAVB increased 30-day mortality.

Area of Science:

  • Cardiology
  • Clinical Research
  • Sex Differences in Medicine

Background:

  • Acute myocardial infarction (AMI) complicated by tachyarrhythmias or high-grade atrioventricular block (HAVB) is associated with increased mortality.
  • Understanding sex-specific differences in these complications is crucial for targeted patient management.

Purpose of the Study:

  • To investigate and compare the incidence of tachyarrhythmias and HAVB in men and women following AMI.
  • To evaluate the association between these arrhythmias and mortality outcomes in both sexes.

Main Methods:

  • Analysis of the Acute Coronary Syndrome Israeli Survey database (2000-2018) including 14,280 patients.
  • Assessment of sex-based differences in the incidence of ventricular tachyarrhythmia (VTA), atrial fibrillation (AF), and HAVB post-AMI.
  • Evaluation of the mortality risk associated with these arrhythmias in men and women.

Main Results:

  • Women had lower rates of early VTA but higher rates of AF and HAVB compared to men.
  • Women showed a higher risk for AF and HAVB post-AMI.
  • Early and late VTAs, AF, and HAVB were linked to increased 30-day mortality.
  • Late VTA and AF remained significant predictors of mortality beyond 30 days.

Conclusions:

  • Sex differences exist in the occurrence of tachyarrhythmias and HAVB following AMI, with women experiencing more AF and HAVB.
  • Both early and late occurrence of VTAs, AF, and HAVB significantly increase short-term mortality risk.
  • Late VTA and AF are associated with increased mortality even after the initial 30-day period, highlighting their long-term prognostic importance.
Abstract

Keywords:
acute myocardial infarctionatrial fibrillationatrioventricular blockventricular arrhythmiawomen

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