BackgroundSeveral studies have demonstrated that females have a higher risk of arrhythmia recurrence after pulmonary vein (PV) isolation for atrial fibrillation (AF). There are limited data on sex‐based differences in PV reconnection rates at repeat ablation. We aimed to investigate sex‐based differences in electrophysiological findings and atrial arrhythmia recurrence after repeat AF ablationMethodsWe conducted a retrospective study of 161 consecutive patients (32% female, age 65 ± 10 years) who underwent repeat AF ablation after index PV isolation between 2010 and 2022. Demographics, procedural characteristics and follow‐up data were collected. Recurrent atrial tachycardia (AT)/AF was defined as any atrial arrhythmia ≥30 s in duration.ResultsCompared to males, females tended to be older and had a significantly higher prevalence of prior valve surgery (10 vs. 2%; P = .03). At repeat ablation, PV reconnection was found in 119 (74%) patients. Males were more likely to have PV reconnection at repeat ablation compared to females (81 vs. 59%; P = .004). Excluding repeat PV isolation, there were no significant differences in adjunctive ablation strategies performed at repeat ablation between females and males. During follow‐up, there were no significant differences in freedom from AT/AF recurrence between females and males after repeat ablation (63 vs. 59% at 2 years, respectively; P = .48).ConclusionsAfter initial PV isolation, significantly fewer females have evidence of PV reconnection at the time of repeat ablation for recurrent AF. Despite this difference, long‐term freedom from AT/AF was similar between females and males after repeat ablation.

中文翻译：

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复发性心房颤动重复消融时的肺静脉重新连接率及其对女性和男性结局的影响

背景多项研究表明，女性因房颤 (AF) 进行肺静脉 (PV) 隔离后心律失常复发的风险较高。关于重复消融时 PV 重新连接率的性别差异的数据有限。我们的目的是调查重复 AF 消融后电生理结果和房性心律失常复发的性别差异方法我们对 2010 年至2022 年。收集了人口统计、程序特征和随访数据。复发性房性心动过速 (AT)/AF 定义为任何持续时间≥30 秒的房性心律失常。 结果与男性相比，女性往往年龄较大，且既往接受过瓣膜手术的患病率显着更高（10% vs. 2%；磷= .03)。在重复消融时，119 名 (74%) 患者发现 PV 重新连接。与女性相比，男性在重复消融时更有可能出现 PV 重新连接（81% vs. 59%；磷= .004)。排除重复PV隔离，女性和男性之间在重复消融时执行的辅助消融策略没有显着差异。随访期间，重复消融后女性和男性的 AT/AF 复发率没有显着差异（2 年时分别为 63% 和 59%；磷= .48)。结论在初次 PV 隔离后，在因复发性 AF 重复消融时有 PV 重新连接证据的女性明显减少。尽管存在这种差异，但重复消融后，女性和男性长期摆脱 AT/AF 的情况相似。