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Sex-Related Differences in Left Atrial Low-Voltage Areas According to CHA(2)DS(2)-VA Scores among Patients with Atrial Fibrillationopen access

Authors
Kim, Do YoungKim, Yun GiChoi, Ha YoungChoi, Yun YoungBoo, Ki YungLee, Kwang-NoRoh, Seung-YoungShim, JaeminChoi, Jong-IlKim, Young-Hoon
Issue Date
Jun-2022
Publisher
MDPI AG
Keywords
atrial fibrillation; catheter ablation; female; sex; electro-anatomical remodeling; low voltage area
Citation
Journal of Clinical Medicine, v.11, no.11
Indexed
SCIE
SCOPUS
Journal Title
Journal of Clinical Medicine
Volume
11
Number
11
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61065
DOI
10.3390/jcm11113111
Abstract
(1) Background: We hypothesized that female sex would have a differential impact on left atrial (LA) low-voltage areas (LVAs) according to CHA(2)DS(2)-VA scores. (2) Methods: This study included 553 patients who underwent radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). LVAs were defined as regions with bipolar peak-to-peak voltages of <0.5 mV. The proportion of LVAs was calculated by dividing the total LVA by the LA surface area. (3) Results: There was no sex-related difference in LA LVAs among patients with a CHA(2)DS(2)-VA scores <= 2. The proportion of LVAs was significantly higher in females among patients with CHA(2)DS(2)-VA scores of 3 or 4 (10.1 (4.7-15.1)% vs. 15.8 (9.2-32.1)%; p = 0.027). Female sex was significantly associated with extensive LVAs (LVA proportion >= 30%). Females had odd ratios of 27.82 (95% confidence interval (CI) 3.33-756.8, p = 0.01), and 1.53 (95% CI 0.81-2.83, p = 0.184) for extensive LAVs in patients with CHA(2)DS(2)-VA scores >= 3 and CHA(2)DS(2)-VA scores < 3, respectively. In the multiple regression model, female patients with a CHA(2)DS(2)-VA >= 3 were significantly associated with a higher proportion of LVAs (beta = 8.52, p = 0.039). (4) Conclusions: Female sex was significantly associated with extensive LVAs, particularly when their CHA(2)DS(2)-VA scores were >= 3. This result suggests that female sex has a differential effect on the extent of LVAs based on the presence of additional risk factors.
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Choi, Jong il
Anam Hospital (Department of Cardiology, Anam Hospital)
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