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Catheter ablation of symptomatic atrial fibrillation: Sex, ethnicity, and socioeconomic disparities
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Cardiology.ORCID iD: 0000-0002-4288-3310
Örebro University, School of Medical Sciences. Department of Cardiology, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-2654-9427
Department of Cardiology, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
2022 (English)In: Heart rhythm O2, E-ISSN 2666-5018, Vol. 3, no 6 Part B, p. 766-770Article, review/survey (Refereed) Published
Abstract [en]

Catheter ablation for treatment of atrial fibrillation (AF), AF ablation, is more effective than antiarrhythmic drugs in reducing AF burden, reducing symptoms and increasing health-related quality of life. Although females more often experience AF-related symptoms, and have more severe symptoms, have lower quality of life, and experience more serious adverse effects of antiarrhythmic drugs than males, they are less likely to undergo AF ablation. Potential explanations for the disparity include older age at diagnosis, longer AF duration, a greater number of comorbidities, more extensive atrial fibrosis, and presumed lower success rate and more complications after AF ablation in women. Studies have failed to show sex-related differences in AF recurrence or serious complications following AF ablation but show more nuisance bleeds in women. Ethnic minorities, such as African Americans and Latin Americans, and individuals of low socioeconomic status are also less likely to undergo AF ablation, possibly associated with greater numbers of comorbidities, lack of patient advocacy, healthcare costs, and inadequate insurance coverage. Inclusion of marginalized patient groups in clinical trials of AF treatment and a personalized, patient-centered approach may expand equality in utilization of AF ablation.

Place, publisher, year, edition, pages
Elsevier, 2022. Vol. 3, no 6 Part B, p. 766-770
Keywords [en]
Atrial fibrillation, Catheter ablation, Ethnicity, Healthcare system, Sex, Socioeconomic factors
National Category
Cardiology and Cardiovascular Disease Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-103124DOI: 10.1016/j.hroo.2022.07.008ISI: 000906816000001PubMedID: 36588997Scopus ID: 2-s2.0-85144048907OAI: oai:DiVA.org:oru-103124DiVA, id: diva2:1727543
Available from: 2023-01-16 Created: 2023-01-16 Last updated: 2025-02-10Bibliographically approved

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Björkenheim, AnnaFengsrud, Espen

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