Abstract 21059: Are There Gender Differences in Outcomes Following Surgical Ablation?
Background: Evidence has shown that female patients arrive for cardiac evaluation sicker than their male counterparts and do not recover as well after an intervention. The purpose of this study was to compare the outcomes of male and female patients who undergo surgical ablation for atrial fibrillation (AF).
Methods: This was a prospective study of all data stored in a comprehensive surgical ablation registry. Rhythm was determined by EKG and/or 24 hour holter. Health related quality of life (HRQL - SF-12) was examined at baseline and 12 months post surgery. The Social Security Death Index and the National Death Index were searched for survival information.
Results: Since 2005, 459 patients have undergone surgical ablation for AF at our institution — 33% female. Females presented with a higher EuroSCORE than males (6.88 ± 2.66 vs 5.59 ± 2.92, p<0.001), more congestive heart failure (48% vs 29%, p<0.001), experienced more concomitant surgery (88% vs 74%, p<0.001), fewer minimally invasive surgeries (7% vs 28%, p<0.001) and a longer length of stay (11.55 ± 14.7 vs 7.98 ± 7.1 days, p<0.01). There were no differences in complications post surgery. Return to sinus rhythm off anti arrythmics was similar for males and females at 6 and 12 months (71% vs. 75%, p=0.47; 79% vs. 80%, p=0.84). There was no difference in survival between males and females (p=0.11). There were significant gender differences in baseline physical component scale (PCS) HRQL with females reporting lower scores (37.52 ± 10.5 vs 42.33± 11.9, p<0.001). Both groups had significant improvement in their PCS scores by 12 months (p<0.001) though females never caught up to the males. Both genders were lower on baseline PCS as compared to their age and gender norms (p<0.001). By 12 months, males were significantly higher on PCS than norms (p<0.05) and females were no longer worse than norms (p=0.08).
Conclusions: Females do present for surgical ablation sicker and in need of more concomitant surgery than their male counterparts. Females can expect to have the same rate of return to sinus rhythm off anti arrhythmic medications and survival rate as well as an increase in HRQL scores . Females should be evaluated and treated earlier for risk factors associated with cardiovascular disease and atrial fibrillation.
- © 2010 by American Heart Association, Inc.