New A-Fib Ablation Therapy Benefits Women as Much as Men

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A procedure to treat the irregular heart rhythm condition known as atrial fibrillation (a-fib) works just as well for women as it does for men, new research shows.

The technology, called pulsed field ablation (PFA), can be used to restore a regular heartbeat.

“These results are important, as women are underrepresented in prior ablation studies and the results have been mixed with regards to both safety and effectiveness using conventional ablation strategies such as radiofrequency or cryoablation,” said study first author Dr. Mohit Turagam, an associate professor of medicine (cardiology) at Icahn School of Medicine at Mount Sinai in New York City. He spoke in a school news release.

About 2.7 million Americans live with some form of a-fib.

The options for treating it include a procedure called catheter ablation, which involves making scars in small areas in the heart involved in the abnormal rhythm. That fix prevents abnormal electrical signals or rhythms from moving throughout the heart.

Two types of ablation are currently in common use. In radiofrequency ablation, heat energy eliminates the problem area. With cryoablation, cold energy is the fix.

These treatments are associated with an increased risk of potential complications, including damage to the esophagus, pulmonary vein stenosis (narrowing) and injury of the phrenic nerve, which is important for breathing.

PFA does not use temperature, but instead short, high-energy electrical pulses that target mainly heart cells. It is more precise than radiofrequency and cryoablation, and does not cause the same damage.

Researchers did a retrospective analysis of more than 1,500 patients from a multinational registry from 24 European centers. It included a-fib patients who underwent their first-ever PFA between March 2021 and May 2022, after the device received regulatory approval in Europe.

The research team categorized patients by sex and evaluated clinical outcomes of PFA within these groups. They studied the elimination of atrial fibrillation and adverse events.

In the end, the team found no significant difference in recurring a-fib in men compared to women. About 79% of men and 76% of women did not have recurring a-fib after PFA.

The rate of patients needing a second ablation was also similar between genders, with men at 8.3% versus women at 10%. That difference was not considered statically significant.

Complication rates from the procedure were low overall. They did not differ significantly by sex, with women at 2.5% versus men at 1.5%.

The findings were published Nov. 1 in the journal JAMA Cardiology.

“For the last few years, the emerging data with pulsed field energy has been quite promising for the treatment of atrial fibrillation. This current analysis … demonstrates that the benefits are not just limited to men. Thus, women should not be denied the beneficial, life-enhancing procedure of catheter ablation for atrial fibrillation,” said senior study author Dr. Vivek Reddy, director of the Cardiac Arrhythmia Service at Icahn Mount Sinai.

More information

The American Heart Association has more on atrial fibrillation.

SOURCE: Icahn School of Medicine at Mount Sinai, news release, Nov. 1, 2023

Source: HealthDay

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