Abstract 12367: Sex-Specific Differences in Quality of Life and Atrial Fibrillation Recurrence Following Ablation of Persistent Atrial Fibrillation: Insights From the DECAAF II Trial

Introduction: Sex-specific differences have been observed in the literature in outcomes of catheter ablation of atrial fibrillation.

Objective: We sought to evaluate sex-specific differences in persistent atrial fibrillation(PeAF) particularly in relation to quality of life and AF recurrence after ablation.

Methods: We examined all PeAF patients in the DECAAF II trial and divided them into 2 groups, women and men. We evaluated sex-based differences in quality of life based on the SF-36 quality of life score. We assessed each component of the score before and after ablation as well as the total score. The Mann-Whitney U test was used. A time-to-event analysis was conducted to assess for AF recurrence.

Results: We included 815 patients(21% women, 79% men). Women experienced more PeAF recurrence(53.3%) after 90 days of the blanking period than men(40.2%) [HR= 1.4311 (1.132, 1.809), p<0.01](Figure 1). SF36 Quality of Life scores showed significant differences between women and men in 9 out of 9 categories both before and after ablation at 12 months. Women consistently reported lower scores than men in physical functioning (p<0.01), physical health(p<0.01), emotional problems(p<0.01), energy and fatigue(p<0.01), emotional wellbeing(p<0.01), social functioning (p<0.01), pain(p<0.01), general health(p<0.01), and health change(p<0.01). Total scores for women remained lower both pre- and post-ablation(p<0.01)(Figure 2).

Conclusion: Female patients with PeAF demonstrated more AF recurrence and consistently poorer quality of life compared to males before and after ablation, indicating the need for further investigation and targeted interventions.