Gender differences in catheter ablation for AF

[Finvola]

I have noticed in some articles comments about heart differences between men and women and started looking into whether these differences may make the outcome of ablation different for men and women. I can find nothing later than 2011 but the articles I have read are very interesting and I wondered if anyone can shed further light either with newer research or comments from their EP's about their experiences. (I certainly intend to ask mine.)

The best article I found was on Medscape and if you don't want to log in then a Google search on 'atrial fibrillation catheter ablation in females' may take you in directly.

medscape.com/viewarticle/75...

This article comments in passing on some structural differences between the sexes (cardiac, that is) and makes good reading. The bottom line seems to be that ablation is more likely to succeed in men. Am I wrong?

[BobD Volunteer]

Sorry but I have no info on that question Finvola. I do know that when I used the lap top ECG machine during heart rhythm week last year I had to tell it if the subject was male or female as there are differences in the trace between genders which it needs to know.

[Finvola in reply to BobD]

Thanks Bob - the research is ancient in terms of ablation's lifetime but I thought it raised some interesting points.

[Icenae]

Well that's interesting. I have had 3 ablations. Only the 2nd worked for a few years. Latest one lots of probs and now have tachycardia rather than a fib mostly. I am female age 64.

[Finvola in reply to Icenae]

The dates of the papers I can find are in the early days of ablations and may have been superceded by technique and skill but the surrounding data is very interesting, I think.

[Coco51]

Very interesting indeed! But on reading this I'm not sure that is the bottom line. Yes there may be a need for a female tailored procedure because of structural heart differences, but it seems to be saying that women get fewer ablations than men (men are treated earlier and more aggressively) and women are more likely to have worse problems than men by the time they get the procedure because they are offered ablation later in the progression of AF and therefore so are more likely to have enlarged atria.

[Finvola in reply to Coco51]

Yes, there seem to be social influences at work as well - which really caught my interest. Other things I noticed were in some of the studies that women tended to be referred less frequently and had failed on more drugs than men before ablation was done (or offered?). It does seem to be a very complex issue and if I get a response from my physician - your idea of a female-tailored procedure - I'll post it.

[BobD Volunteer in reply to Finvola]

A few years ago there was an article about the differences in the way ladies present to doctors against men. I am sure that we all now of ladies who have been patronised by their GP over AF being told that it " it's your age dear" or " it is panic attacks" both of which are insulting. It also discussed another fact that ladies tend to try to maintain a good "face" to the world so will make sure that they are made up. hair done etc before a trip to the doctors whereas men may turn up unshaven and dishevelled and thus appear more ill. It may well be for these reasons that females tend to take longer to get treatment and therefore have more entrenched conditions which make successful outcomes less likely.

Moral ladies, slum it when going to see your GP.

Bob

[Lizty]

Many years ago a male friend, who worked locally, told me that he had suffered really bad palpitations a few weeks before, and his partner had taken him to A and E, worried he might be having a heart attack. When he described his symptoms I said, 'Oh, I get that sometimes when I have got really overtired.... the doctor just says it's low blood pressure and to get some rest.....' Since being diagnosed with AF, i have often thought..... why did I never go to A and E ????