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Updated: Jul 11, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Sex-specific outcomes after catheter ablation for persistent AF
Louise Segan1, David Chieng1, Rose Crowley1
1The Baker Heart and Diabetes Research Institute, Melbourne, Victoria, Australia; The Alfred Hospital, Department of Cardiology, Melbourne, Victoria, Australia; University of Melbourne, Melbourne, Victoria, Australia; Monash University, Melbourne Victoria, Australia; Cabrini Hospital, Department of Cardiology, Melbourne, Victoria, Australia.
Women undergoing catheter ablation for persistent atrial fibrillation experience higher recurrence rates and more repeat procedures. However, both sexes show significant improvements in quality of life and psychological well-being post-ablation.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Research
Background:
- Sex-specific outcomes after catheter ablation (CA) for atrial fibrillation (AF) remain unclear, with conflicting findings in previous studies.
- Persistent AF (PsAF) presents unique challenges, and understanding sex differences in treatment response is crucial.
Purpose of the Study:
- To investigate the impact of female sex on outcomes in patients with persistent AF undergoing catheter ablation.
- To compare clinical characteristics, arrhythmia recurrence, and quality of life between women and men after PsAF ablation.
Main Methods:
- A randomized trial (CAPLA) involving 338 patients with PsAF randomized to pulmonary vein isolation (PVI) or PVI with posterior wall isolation (PWI).
- Primary outcome was arrhythmia recurrence at 12 months; secondary outcomes included clinical and electroanatomical characteristics, and quality of life (QoL) using validated questionnaires.
Main Results:
- Women (23.4%) were older and had more advanced left atrial remodeling than men.
- Arrhythmia-free survival was lower in women (44.3%) compared to men (56.8%) at 12 months (P = .036).
- Women reported more severe baseline anxiety and AF symptoms but showed comparable improvements in psychological well-being and greater QoL improvement post-ablation.
Conclusions:
- Women with PsAF experience poorer baseline QoL and more symptoms but achieve significant QoL improvements post-ablation.
- Despite higher recurrence rates and repeat procedures in women, AF burden was comparable, suggesting other factors influence outcomes.
- The study highlights the need for sex-specific considerations in managing persistent AF patients undergoing catheter ablation.
