Gender-Specific Effects on Quality of Life and Physical Activity After Pulmonary Vein Isolation: A Secondary Analysis of a Randomized Controlled Trial

IF 1.6 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of interventional cardiology Pub Date : 2025-02-18 DOI:10.1155/joic/3825972

Daniel Meretz, Martin Seifert, Anja Haase-Fielitz, Christian Georgi, Marwin Bannehr, Viviane Moeller, Hans-Heinrich Minden, Dirk Große Meininghaus, Gerhard Janßen, Christian Butter

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引用次数: 0

Abstract

Background: Gender differences exist in atrial fibrillation (AF) regarding epidemiology, mechanisms, management, and outcomes. There are limited data regarding gender-specific outcomes after pulmonary vein isolation (PVI) including AF recurrence, physical activity, and health-related quality of life.

Methods: In this secondary analysis of a randomized controlled trial (BE-ACTION study: investigating 200 patients with paroxysmal or persistent AF undergoing PVI), a gender-specific analysis of the primary endpoint (recurrence of atrial arrhythmia > 30s, additional ablation procedure, or new onset of antiarrhythmic drugs) was performed. Quality of life was assessed using the AFEQT and SF-36 questionnaires, while physical activity was measured via step counts recorded at baseline, 6 months, and 12 months. The Mann–Whitney U test and Fisher exact test were used to compare continuous and categorical variables, respectively.

Results: 33.5% were women. Women and men were comparable in demographics, comorbidities, and steps per day before and after PVI. There was no statistically significant difference in the primary composite endpoint between women (37.3%) and men (25.6%) (p = 0.085). Before PVI, women had lower quality of life scores than men (median AFEQT scores: 43.5 points [25^th to 75^th percentiles 25.9–63.9] vs. 62.0 points [47.2–76.4], respectively, p < 0.001) as well as in the physical (40.22 points [33.98–46.69] vs. 46.30 points [39.21–51.60], p = 0.002) and mental domains (42.33 points [27.34–51.59] vs. 49.59 points [36.02–55.64], p = 0.001) of the SF-36 questionnaire. The overall improvement in the quality of life was significant for both men and women (p < 0.001). Using AFEQT, women exhibited lower quality of life scores compared to men at 6 months post-PVI (p = 0.001); however, this difference was no longer statistically significant at 12 months (p = 0.077).

Conclusion: These data emphasize the importance of AF recurrence after PVI and motivate future research to explore the causes and clinical consequences of a gender gap in quality of life in women after PVI.

Trial Registration: BE-ACTION Study ClinicalTrials.gov identifier: DRKS00012914

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肺静脉隔离术后不同性别对生活质量和体育锻炼的影响：随机对照试验的二次分析

背景：房颤（AF）在流行病学、机制、治疗和结局方面存在性别差异。关于肺静脉隔离（PVI）后性别特异性结局（包括房颤复发、身体活动和健康相关生活质量）的数据有限。方法：在一项随机对照试验（BE-ACTION研究：调查200例接受PVI治疗的阵发性或持续性房颤患者）的二级分析中，对主要终点(房性心律失常复发>；30，额外消融手术，或新发作的抗心律失常药物)。使用AFEQT和SF-36问卷评估生活质量，同时通过基线、6个月和12个月记录的步数来测量身体活动。分别采用Mann-Whitney U检验和Fisher精确检验比较连续变量和分类变量。结果：33.5%为女性。女性和男性在人口统计学、合并症和PVI前后每天步数方面具有可比性。女性（37.3%）和男性（25.6%）的主要综合终点无统计学差异（p = 0.085）。在PVI之前，女性的生活质量评分低于男性(AFEQT评分中位数：43.5分[25 - 75百分位数25.9-63.9]vs. 62.0分[47.2-76.4],p <；在SF-36问卷的生理（40.22分[33.98-46.69]比46.30分[39.21-51.60],p = 0.002）和心理（42.33分[27.34-51.59]比49.59分[36.02-55.64],p = 0.001）。生活质量的整体改善对男性和女性都是显著的(p <；0.001)。使用AFEQT，女性在pvi后6个月的生活质量评分低于男性（p = 0.001）；然而，在12个月时，这种差异不再具有统计学意义（p = 0.077）。结论：这些数据强调了PVI后房颤复发的重要性，并激发了未来研究探索PVI后女性生活质量性别差异的原因和临床后果。试验注册：BE-ACTION Study ClinicalTrials.gov标识符：DRKS00012914

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来源期刊

Journal of interventional cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.80

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Interventional Cardiology is a peer-reviewed, Open Access journal that provides a forum for cardiologists determined to stay current in the diagnosis, investigation, and management of patients with cardiovascular disease and its associated complications. The journal publishes original research articles, review articles, and clinical studies focusing on new procedures and techniques in all major subject areas in the field, including: Acute coronary syndrome Coronary disease Congenital heart diseases Myocardial infarction Peripheral arterial disease Valvular heart disease Cardiac hemodynamics and physiology Haemostasis and thrombosis