Author + information
- Fahd Yunusa,b,
- George Leefa,b,
- Andrew Cluckeya,b,
- Mariam Askaria,b,
- Ewoud Schuita,b,
- Paul Heidenreicha,b,
- Mintu Turakhiaa,b and
- Alexander Perinoa,b
Background: Women comprise 45% of atrial fibrillation (AF) patients in the U.S. and undergo 40% of catheter ablations. We sought to describe the inclusion of women in the AF ablation evidence base.
Methods: We performed a systematic review and meta-analysis of AF ablation from 1/1/1990 to 8/1/2016 searching PubMed, Scopus, and Cochrane databases. The full protocol is registered with PROSPERO. We included trials and observational studies reporting AF ablation success rate, safety profile, quality of life outcomes, or cost. We grouped treatment arms by paroxysmal AF (PAF) and non-paroxysmal AF (NPAF) type and stratified by year of publication. Analyses used the DerSimonian and Laird method with random-effects.
Results: A total of 292 studies were included (PAF: 276 treatment arms, 35,117 patients; NPAF: 117 treatment arms, 13,201 patients). In PAF treatment arms, female prevalence ranged from 11-57% with a 1.2% increase per year (p<0.001) reaching 36% in 2016 (Figure). In NPAF treatment arms, female prevalence ranged from 2.5-50% with a 0.4% increase per year (p 0.08), reaching 30% in 2016. No study stratified ablation success rates by gender.
Conclusions: Inclusion of women in AF ablation studies is rising slowly, but the proportion of women in these studies lags behind the proportion receiving the procedure in clinical practice. Gender- or sex-stratified results are frequently not published. Investigation of barriers to enrollment of women in AF ablation studies or publication of results is warranted.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation and VT: Incorporating Novel Risks Toward Decision Making
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1280-098
- 2017 American College of Cardiology Foundation