Sex- and Age-Dependent Outcomes of Cryoablation in Atrial Fibrillation: A 3- and 6-Month Post-Procedural QoL Analysis

Cryoablation is an established treatment for atrial fibrillation (AF), offering effective rhythm control and symptomatic improvement. However, short-term trajectories of quality-of-life (QoL) recovery-particularly regarding age- and sex-related differences-remain insufficiently characterized. This study evaluated patterns of functional and emotional improvement within 3 and 6 months after cryoablation.

A prospective observational cohort of 150 patients undergoing cryoablation for AF was analyzed. QoL was assessed using the 36-item short form (SF) (Physical and Mental Component Scores PCS and MCS) survey at baseline, 3 months, and 6 months.

Significant improvements were observed across all SF-36 (57.5 at baseline to 77.1 at 3-months and 80.1 at 6-months, p < 0.001), PCS and MCS between baseline and follow-up (main effect of time p < 0.001). An age × time interaction showed that younger patients (≤ 65 years) demonstrated greater functional gains both in 3 and 6 months compared to older adults (p < 0.001 for all). A sex × time interaction was also noted for SF-36 (p = 0.046) and PCS (p = 0.038), reflecting a trend for a more rapid improvement in men versus women. These sex differences were non-significant after Bonferroni adjustment. Multivariable regression confirmed younger age as the strongest independent predictor of improvement (β = 18.2, p < 0.001), followed by paroxysmal AF type and baseline ejection fraction.

Cryoablation leads to substantial QoL improvements. While age is a robust independent predictor of recovery, sex-specific differences in physical and emotional trajectories appear as notable trends requiring further investigation. These findings emphasize the need for individualized post-procedural counseling and follow-up tailored to demographic recovery profiles.