Sex-Related Differences in Non–Pulmonary Vein Triggers During Initial Atrial Fibrillation Ablation

What are the sex-specific differences in prevalence, type, and site of origin of non–pulmonary vein (PV) triggers among patients undergoing first-time ablation for atrial fibrillation (AF)?In this cohort study of 2038 patients, the prevalence of non-PV triggers was higher among women than men (10.8% vs 6.6%), largely owing to a higher rate of right atrial foci. Women with non-PV triggers were more likely to have multiple triggers and worse postablation outcomes.This study suggests that sex is significantly associated with the prevalence and characteristics of non-PV triggers identified during AF ablation, highlighting the need for a personalized approach to provoking, localizing, and ablating AF triggers among women and men.

Corresponding Author: Francis E. Marchlinski, MD, Section of Cardiac Electrophysiology, Division of Cardiovascular Medicine, Department of Medicine, Hospital of the University of Pennsylvania, 1 Convention Ave, Pavilion, 2nd Floor City Side, Philadelphia, PA 19104 (francis.marchlinski@pennmedicine.upenn.edu).

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