Cardiology · General Practice · 4 h ago
Women with atrial fibrillation were less likely to undergo ablation in cohort study
A retrospective cohort study of 165,563 patients with incident atrial fibrillation in the Northwell Health ITHACA database found sex differences in care pathways and outcomes. Women were less likely than men to receive catheter ablation and had higher adjusted rates of stroke and dementia during follow-up.
- Women were less likely to receive catheter ablation.
- Cardiology and electrophysiology evaluations were less common in women.
- Female sex was associated with higher adjusted stroke and dementia rates.
- Retrospective findings do not establish causes of care differences.
Researchers analyzed patients with incident atrial fibrillation (AF) recorded in the Northwell Health ITHACA database between 2015 and 2024. The cohort included 165,563 patients; 45% were women, and mean age was 71.4 years. The study examined clinical characteristics at diagnosis, progression through cardiology and electrophysiology care to catheter ablation, and long-term outcomes. Median follow-up was 3.6 years, with 96% retention.
Women were older at diagnosis than men and more often had dementia, stroke, or congestive heart failure. Fewer women than men were evaluated by cardiology (31.5% vs. 35.3%) or electrophysiology (16.2% vs. 21.6%), and fewer underwent catheter ablation (3.5% vs. 5.7%). Women were 16% less likely to receive ablation (risk ratio 0.84, 95% CI 0.77–0.91). Adjusted analyses associated female sex with higher rates of incident stroke (aHR 1.24) and dementia (aHR 1.30), but slightly lower mortality (aHR 0.96).
The findings identify sex differences in care and outcomes in this health-system cohort, but the retrospective design cannot establish why they occurred or whether differences in care caused outcome differences. The results may not generalize beyond the study setting.
In practice
In this retrospective Northwell Health cohort of 165,563 people with incident AF, women were less likely than men to reach cardiology or electrophysiology evaluation and catheter ablation, and female sex was associated with higher adjusted rates of stroke and dementia. These findings highlight potential differences in the AF care pathway that may merit attention when evaluating referral patterns. They do not show that referral or ablation differences caused the outcome differences, establish reasons for the care gaps, or prove the results apply to other health systems.
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European Journal of Preventive Cardiology: Sex-based differences in the atrial fibrillation care pathway and outcomes: an ITHACA-database analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.