Background:When presenting for atrial fibrillation (AF) ablation, women, compared with men, tend to have more nonpulmonary vein triggers and advanced atrial disease. Whether this informs differences in AF ablation strategy is not well described. We aimed to characterize ablation strategy and complications by sex, using the Get With The Guidelines-AF registry.Methods:From the Get With The Guidelines-AF registry ablation feature, we included patients who underwent initial AF ablation procedure between January 7, 2016, and December 27, 2019. Patients were stratified based on AF type (paroxysmal versus nonparoxysmal) and sex. We compared patient demographics, ablation strategy, and complications by sex.Results:Among 5356 patients from 31 sites who underwent AF ablation, 1969 were women (36.8%). Women, compared with men, were older (66.8±9.6 versus 63.4±10.6, P<0.0001) and were more likely to have paroxysmal AF (59.4% versus 49.5%, P<0.0001). In women with nonparoxysmal AF, left atrial linear ablation was more frequent (roof line: 53.9% versus 45.3%, P=0.0002; inferior mitral isthmus line: 10.2% versus 7.0%, P=0.01; floor line: 46.1% versus 40.6%, P=0.02) than in men. In multivariable analysis, the association between patient sex and complications from ablation was not statistically significant.Conclusions:In this US wide AF ablation quality improvement registry, women with nonparoxysmal AF were more likely to receive adjunctive lesion sets compared with men. These findings suggest that patient sex may inform ablation strategy in ways that may not be strongly supported by evidence and emphasize the need to clarify optimal ablation strategies by sex.

中文翻译：

---

心房颤动导管消融的消融策略、病变组和并发症的性别差异：来自 GWTG-AFIB 注册的分析

背景：在接受房颤 (AF) 消融治疗时，与男性相比，女性往往有更多的非肺静脉触发因素和晚期心房疾病。这是否会影响 AF 消融策略的差异还没有得到很好的描述。我们的目标是使用 Get With The Guidelines-AF 登记表按性别描述消融策略和并发症。和 2019 年 12 月 27 日。根据 AF 类型（阵发性与非阵发性）和性别对患者进行分层。我们按性别比较了患者的人口统计学、消融策略和并发症。结果：在来自 31 个地点的 5356 名接受 AF 消融的患者中，1969 名是女性（36.8%）。与男性相比，女性年龄更大（66.8±9.6 对 63.P <0.0001）并且更可能患有阵发性 AF（59.4% 对 49.5%，P <0.0001）。在非阵发性 AF 女性中，左心房线性消融更频繁（顶线：53.9% 对 45.3%，P =0.0002；二尖瓣下峡线：10.2% 对 7.0%，P =0.01；底线：46.1% 对 40.6% , P=0.02) 比男性。在多变量分析中，患者性别与消融并发症之间的关联无统计学意义。结论：在这项美国广泛的 AF 消融质量改进登记中，与男性相比，非阵发性 AF 女性更可能接受辅助病变组。这些发现表明，患者性别可能会以可能没有证据强烈支持的方式告知消融策略，并强调需要按性别阐明最佳消融策略。