Are women with AF being under-treated with ablation?

This post is an introduction to commentary I made recently over at theHeart.org on Medscape. Gender features in the discussion, but there are lessons for men and women with AF. *** A large study from a group of Stanford researchers made three big observations on AF ablation: Women, compared with men, presented for first AF ablation at an older age and with more risk factors (higher CHADSVASC score.) At 30 days after the ablation, women compared with men, suffered from more complications. At one year after the ablation, women compared with men, had more re-hospitalizations but fewer cardioversions and repeat AF ablation. The first two findings confirmed results of previous studies. For whatever reason, it’s not well-understood, women who come for first ablation often have more advanced atrial disease. It’s also well established in cardiology, not only EP, that women have higher rates of complications with procedures. The third finding was provocative. It tempts one to think women are getting cheated out of repeat ablation and cardioversions. Here are the Stanford authors (italics mine): “Our findings, in context, may be indicative of potential barriers to optimal or sustained rhythm-control strategies in women. . . . These data call for greater examination of barriers and facilitators to sustain rhythm-control strategies in women.” A reader could infer two benevolent biases in these words: women are getting stiffed out of more cardioversions and AF a...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs