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A. Basics
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
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26. Cardiovascular Surgery
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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Sex differences in atrial structure, function, and atrial fibrillation recurrence after pulmonary vein isolation
Session:
Sessão de Posters 17 - O género importa em cardiologia
Speaker:
Luísa Pinheiro
Congress:
CPC 2026
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.2 Cardiovascular Disease in Women
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Ana Lucy Calvo; Luísa Pinheiro; Emídio Mata; Bárbara Lage Garcia; Filipa Castro; Margarida de Castro; Daniela Ferreira; Joana Gomes; Sílvia Ribeiro; Olga Azevedo; António Lourenço
Abstract
<p>Background: Sex differences in atrial fibrillation (AF) presentation, cardiac structure, and treatment response are increasingly recognized. Despite being underrepresented in ablation trials, women often show greater structural remodeling and symptom burden. Whether these differences affect outcomes and recurrence after pulmonary vein isolation (PVI) remains under investigation. </p> <p>Purpose: To compare baseline echocardiographic characteristics and long-term arrhythmia recurrence between female and male patients undergoing first-time AF catheter ablation. </p> <p>Methods: This retrospective study included 72 consecutive patients (28 women, 44 men) who underwent first-time PVI (2015-2024) with available echocardiogram. Demographic, clinical, and echocardiographic data, including left atrial strain (LAS) parameters, were analysed. Arrhythmia recurrence was assessed at 1 and 3 years post-ablation using 12-lead ECG and Holter monitoring. Kaplan–Meier analysis was used to evaluate recurrence-free survival. </p> <p>Results: Women were significantly older than men (64.6±7.2 vs 58.5±10.4 years, p<0.01), with similar prevalence of comorbidities - hypertension, diabetes, chronic kidney disease, and sleep apnea. The median interval between echocardiography and PVI was 312 days [IQR 120–610]. Symptom burden was comparable between sexes. Echocardiographic evaluation showed no significant differences in LA volume index (34.3±9.6 vs 33.2±9.7?mL/m² p=0.67) or LV function. A trend toward higher E/e′ ratio in women was noted (9.2±4.0 vs7.0±1.8 p=0.05). LAS of reservoir and LAS of conduit were similar, but women exhibited significantly higher contractile LAS (14.4% vs 11.95% p=0.02), potentially indicating preserved atrial booster function. The mean follow-up was 652.6±576.6 days. AF recurrence did not differ significantly between sexes at 1 year (HR 1.61 [0.56–4.63] p=0.38) or at 3 years (HR 1.64 [0.61–4.43] p=0.33). </p> <p>Conclusions: Although women were older and had higher E/e′ ratio, they showed similar left atrial structure and LAS parameters to men, with higher contractile strain. No significant sex differences in AF recurrence were observed at 1- and 3-year follow-up which may be explained by smaller sample size. Limitations include the retrospective single-center design, intermittent monitoring that may miss asymptomatic recurrences, high follow-up dropout rates, and selection bias. These results underscore the need for further study of sex-specific factors in AF management. </p>
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