دورية أكاديمية
Impact of Female Sex on Clinical Presentation and Ablation Outcomes in the CIRCA-DOSE Study.
| العنوان: | Impact of Female Sex on Clinical Presentation and Ablation Outcomes in the CIRCA-DOSE Study. |
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| المؤلفون: | Yao RJR; Heart Rhythm Services, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Macle L; Montreal Heart Institute, Department of Medicine, Université de Montréal, Montreal, Quebec, Canada., Deyell MW; Heart Rhythm Services, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Tang L; Data Science Institute, Vancouver, British Columbia, Canada., Hawkins NM; Heart Rhythm Services, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Sedlak T; Heart Rhythm Services, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Nault I; Université Laval, Quebec City, Quebec, Canada., Verma A; Southlake Regional Health Centre, Newmarket, Ontario, Canada., Khairy P; Heart Rhythm Services, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Andrade JG; Heart Rhythm Services, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Montreal Heart Institute, Department of Medicine, Université de Montréal, Montreal, Quebec, Canada. Electronic address: Jason.andrade@vch.ca. |
| مؤلفون مشاركون: | CIRCA-DOSE Study Investigators |
| المصدر: | JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2020 Aug; Vol. 6 (8), pp. 945-954. Date of Electronic Publication: 2020 Jul 29. |
| نوع المنشور: | Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101656995 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2405-5018 (Electronic) Linking ISSN: 2405500X NLM ISO Abbreviation: JACC Clin Electrophysiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York, NY] : Elsevier Inc., [2015]- |
| مواضيع طبية MeSH: | Atrial Fibrillation*/epidemiology , Atrial Fibrillation*/surgery , Catheter Ablation* , Cryosurgery*, Female ; Humans ; Male ; Prospective Studies ; Quality of Life ; Time Factors ; Treatment Outcome |
| مستخلص: | Objectives: This study sought to evaluate sex-specific differences in atrial fibrillation (AF) presentation and catheter ablation outcomes in the prospective, multicenter, randomized CIRCA-DOSE (Cryoballoon vs. Irrigated Radiofrequency Catheter Ablation: Double Short vs. Standard Exposure Duration) study. Background: Similar to other cardiovascular conditions, significant sex-specific differences have been observed in the epidemiology, pathophysiology, presentation, and natural history of AF. Unfortunately, there are major gaps in our understanding of the pathophysiological basis for the observed sex-specific differences and their implications on therapy and prognosis. Methods: This study examined sex-specific differences in AF presentation, symptom severity and health-related quality of life, symptomatic and asymptomatic arrhythmia recurrence, AF burden, and health care utilization. Results: Freedom from any atrial tachyarrhythmia and symptomatic atrial tachyarrhythmia were similar between male (hazard ratio: 1.18; 95% confidence interval: 0.85 to 1.64; p = 0.39) and female patients (hazard ratio: 1.00; 95% confidence interval: 0.62 to 1.59; p = 0.92). Post-ablation, the median AF burden (percentage time in AF) was 0.00% (interquartile range: 0.00% to 0.16%) in male patients and 0.00% (interquartile range: 0.00% to 0.17%) in female patients, with no difference observed between the sexes (p = 0.30). Periprocedural complications occurred twice as frequently in female patients (3.5% vs. 7.0%; p = 0.18). In comparison to male patients, female patients reported a significantly worse symptom score and quality of life at baseline and all follow-up intervals, but they derived similar magnitude of improvement post-ablation. There was no difference between male and female patients with respect to emergency department visits, hospitalization, cardioversion, or repeat ablation. Conclusions: When compared with male patients, female patients have significantly worse symptom scores and quality of life at baseline. Despite this, female patients with symptomatic paroxysmal AF derive similar benefit in freedom from recurrent arrhythmia and similar improvements in quality of life following AF ablation. (Cryoballoon vs. Irrigated Radiofrequency Catheter Ablation: Double Short vs. Standard Exposure Duration [CIRCA-DOSE]; NCT01913522). (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.) |
| التعليقات: | Comment in: JACC Clin Electrophysiol. 2020 Aug;6(8):955-957. (PMID: 32819530) |
| فهرسة مساهمة: | Keywords: ablation; atrial fibrillation; cryoablation; pulmonary vein isolation; radiofrequency; sex differences |
| سلسلة جزيئية: | ClinicalTrials.gov NCT01913522 |
| تواريخ الأحداث: | Date Created: 20200822 Date Completed: 20210818 Latest Revision: 20210818 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1016/j.jacep.2020.04.032 |
| PMID: | 32819529 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 2405-5018 |
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| DOI: | 10.1016/j.jacep.2020.04.032 |