Women and atrial fibrillation

• Published in: Journal of cardiovascular electrophysiology Vol. 32; no. 10; pp. 2793 - 2807
• Main Authors: Volgman, Annabelle Santos, Benjamin, Emelia J., Curtis, Anne B., Fang, Margaret C., Lindley, Kathryn J., Naccarelli, Gerald V., Pepine, Carl J., Quesada, Odayme, Vaseghi, Marmar, Waldo, Albert L., Wenger, Nanette K., Russo, Andrea M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.10.2021
• Subjects: Arrhythmia; Cardiac arrhythmia; catheter ablation; Congestive heart failure; Dementia disorders; Fibrillation; Gender differences; left atrial appendage closure; Quality of life; Sex differences; Stroke; stroke prevention; Women; catheter ablation; left atrial appendage closure; quality of life; stroke prevention; women
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/jce.14838

Atrial fibrillation (AF) remains a growing problem in the United States and worldwide, imposing a high individual and health system burden, including increased resource consumption due to repeated hospitalizations, stroke, dementia, heart failure, and death. This comprehensive review summarizes the most recent data on sex‐related differences in risks associated with AF. Women with AF have increased risk of stroke and death compared to men, and possible reasons for this disparity are explored. Women also continue to have worse symptoms and quality of life, and poorer outcomes with stroke prevention, as well as with rate and rhythm control management strategies. Many current rhythm control treatment strategies for AF, including cardioversion and ablation, are used less frequently in women as compared to men, whereas women are more likely to be treated with rate control strategies or antiarrhythmic drugs. Sex differences should be considered in treating women with AF to improve outcomes and women and men should be offered the same interventions for AF. We need to improve the evidence base to understand if variation in utilization of rate and rhythm control management between men and women represents health inequities or appropriate clinical judgement.