Female Sex Independently Associated With Worse Catheter Ablation Outcomes in Afib

catheter ablation
Women have higher rates of complications and hospital readmission following atrial fibrillation ablation independent of age, comorbidities, and hospital factors.

Compared with men, women have higher rates of complications and hospital readmission following atrial fibrillation (AF) ablation, according to study results published in the European Heart Journal.

The study included participants undergoing AF ablation between 2010 and 2014 from the United States Nationwide Readmissions Database (n=54,597). The researchers used International Classification of Diseases, Ninth Revision, Clinical Modification codes to identify comorbidities and outcomes. They performed multivariable logistic regression and inverse probability-weighting analysis to assess female sex as a predictor of end points.

Of all participants, 37.7% (n=20,623) were female. The median length of hospital stay during index admission for AF ablation was 1.0 days. The overall rate of in-hospital mortality was 0.16% and the rate of any complication was 6.6%.

After adjusting for age, comorbidities, and hospital factors, the results indicated that women had higher rates of any complication (adjusted odds ratio [aOR], 1.39; P <.0001), cardiac perforation (aOR, 1.39; P =.006), and bleeding/vascular complications (aOR, 1.49; P <.0001) compared with men. In addition, women had higher 30-day all-cause readmission rates compared with men (13.4% vs 9.4%; P <.0001).

The results indicated that female sex was independently associated with readmission for AF/atrial tachycardia (aOR, 1.48; P <.0001), cardiac causes (aOR, 1.40; P <.0001), and all causes (aOR, 1.25; P <.0001).

The researchers found that despite increased complications and readmissions, the total costs for AF ablation were lower in women compared with men due to decreased use of resources.

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“Our findings underscore the importance of recognizing and distinguishing between sex-based differences and disparities that explain worse outcomes among women after AF ablation,” wrote the researchers.


Cheung JW, Cheng EP, Wu X, et al. Sex-based differences in outcomes, 30-day readmissions, and costs following catheter ablation of atrial fibrillation: the United States Nationwide Readmissions Database 2010-14 [published online March 29, 2019]. Eur Heart J. doi:10.1093/eurheartj/ehz151