Abstract 15576: Long-Term Catheter Ablation Outcome in Females with Metabolic Syndrome
Introduction: Female gender and metabolic syndrome (MS) are two well-known risk factors of atrial fibrillation (AF). This study examined the combined impact of both risk factors on ablation outcome in AF patients in terms of recurrence.
Method: This prospective study included 1406 consecutive patients undergoing their first catheter ablation for AF [32% paroxysmal AF (PAF); 24% persistent (PER); 44% long-standing persistent (LSP)]. Patients with MS were classified into Group 1(n=373, 64±8 years, 288 (77%) male, LVEF 55±12) and without MS into Group 2 (n=1033, 62±11 years, 714 (69%) male, LVEF 57±9). Follow-up ECG and Holter monitoring were performed at 3, 6, 9 and 12 months to assess AF recurrence.
Result: At 21±7 months follow-up, 90/288 (33%) males and 38/85 (45%) females in group 1 (log-rank p=0.012) and 137/714 (19%) males and 79/319 (25%) females in group 2 (log-rank p= 0.044) had recurrence. To examine the interactive effect we assessed the risk for females in the Non-MS population (ignoring MS) and risk of MS among males (ignoring female). Multivariate Cox model revealed that 1) in the non-MS population female gender showed increased risk of recurrence [hazard ratio (HR)1.2 (0.96-1.74), p=0.05], 2) MS was associated with higher failure among males [HR1.5 (1.16-2.01), p=0.002]. In the overall population, females with MS (joint relation of gender and MS) had significantly higher probability for AF recurrence (HR 2.8 (1.6-3.8), p<0.001) which was interestingly greater than the added odds of risk of being females or having MS alone (2.8>1.2+ 1.5).
Conclusion: Female AF patients with MS are at a significantly higher risk of having post-ablation recurrence than females without MS or males with MS. When concurrently present, the combined influence of female gender and MS exceeds the simple additive impact of the individual factors.
- © 2012 by American Heart Association, Inc.