Sex differences in presentation of atrial fibrillation : Findings from 30-day ambulatory monitoring in real-world practice

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Tan, Jian LiangRowan University (author)

Sex differences in presentation of atrial fibrillation : Findings from 30-day ambulatory monitoring in real-world practice

Article/chapterEnglish2022

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Elsevier BV,2022

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LIBRIS-ID:oai:lup.lub.lu.se:43fef20f-553d-4966-898d-075e852b768b
https://lup.lub.lu.se/record/43fef20f-553d-4966-898d-075e852b768bURI
https://doi.org/10.1016/j.ahjo.2022.100208DOI

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Language:English
Summary in:English

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Background: Women are less likely to receive oral anticoagulation or ablation for treatment of atrial fibrillation (AF). Identification of sex differences in arrhythmia characteristics and symptoms may lead to a better understanding of potential reasons for these differences. Objectives: To determine sex differences in AF with respect to heart rate, duration, burden, and symptoms in patients undergoing mobile cardiac telemetry (MCT) monitoring. Methods: All patients who registered for ≤30-day MCT using PocketECG (MediLynx) in the USA in 2017 were included (n = 27,512, 58 % women). PocketECG records and transmits a three-lead ambulatory electrocardiogram (ECG) with real-time beat-to-beat analysis. Sex-related differences were analyzed with Chi2 and Spearmans rho. Results: Fewer women than men were diagnosed with AF lasting ≥30s (13.7 % versus [vs] 19.0 %, p < 0.001). AF burden was lower in women in all age groups <90 years (all p < 0.01). Women were older at the time of AF diagnosis (median 76 vs 73 years, p < 0.001), had faster heart rate during AF (mean: 104.7 ± 26.0 vs 96.7 ± 26.7 bpm, p < 0.001), and shorter AF duration (mean: 96.2 ± 176.0 vs 121.6 ± 189.9 min, p < 0.001). There was a non-significant trend toward more symptoms (such as dizziness, racing heart, fatigue, or palpitations) during AF in women compared to men (46.5 % vs 43.7 %, p = 0.062). Conclusions: AF was less prevalent and occurred at lower burdens in women than men in each age strata. Despite faster heart rates in AF in women, there were no significant sex differences in reported symptoms during AF. Sex differences in therapy cannot be explained by differences in symptoms or rates in AF. Condensed abstract: Real-world data on sex differences in AF using a 30-day MCT monitoring device remain scarce. We aim to determine the sex differences in AF with respect to prevalence, burden, heart rate, and symptom in patients undergoing ≤30-day MCT monitoring. Our data analysis suggests that fewer women than men had AF, women were older at diagnosis of AF, and women with AF had higher mean heart rate, shorter mean AF duration, and lower mean AF burden than men. Further studies are needed to examine reasons for sex differences, specifically in relation to AF therapy and its impact on clinical outcomes.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Arrhythmia
Atrial fibrillation
Mobile cardiac telemetry
Sex differences

Added entries (persons, corporate bodies, meetings, titles ...)

Johnson, LindaLund University,Lunds universitet,Kardiovaskulär forskning - epidemiologi,Forskargrupper vid Lunds universitet,Cardiovascular Research - Epidemiology,Lund University Research Groups(Swepub:lu)med-laj (author)
Dziubinski, MarekMEDICALgorithmics (author)
Napiorkowski, NatanMEDICALgorithmics (author)
Witkowska, OlgaMEDICALgorithmics (author)
Slusarczyk, Magdalena E.MEDICALgorithmics (author)
Healey, Jeff S.Population Health Research Institute, Ontario (author)
Russo, Andrea M.Rowan University (author)
Rowan UniversityKardiovaskulär forskning - epidemiologi (creator_code:org_t)

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In:American Heart Journal Plus: Cardiology Research and Practice: Elsevier BV222666-6022

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By the author/editor: Tan, Jian Liang; Johnson, Linda; Dziubinski, Mare ...; Napiorkowski, Na ...; Witkowska, Olga; Slusarczyk, Magd ...; show more...; Healey, Jeff S.; Russo, Andrea M.; show less...

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