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Are women harder to ablate?

Posted by tobherd 
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tobherd
Are women harder to ablate?
June 06, 2013 02:43PM
It seems to me that I read here awhile back that women are harder to ablate due to smaller hearts. Is there any truth to that? It does seem that there are a lot more males with this condition...but not sure if a female's success rate is a bit lower based on having smaller hearts..

Anyone?

Barb
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Murray L
Re: Are women harder to ablate?
June 06, 2013 02:47PM
Interesting concept. I am in the exact OPPOSITE situation with a Left Atrium at 55mm at present and waiting for it to drop under 50 mm to enhance chances of a successful ablation. I don't imagine that a woman's heart is much smaller than the average normal sized heart. Anyone?

Murray L

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Tikosyn uptake Dec 2011 500ug b.i.d. NSR since!
Herein lies opinion, not professional advice, which all are well advised to seek.
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Iatrogenia
Re: Are women harder to ablate?
June 06, 2013 03:12PM
In his Webcast a couple of weeks ago, Steven Hao of CMPC said there is no evidence women are more difficult or that outcomes are any different.

He did say women's heart problems are often misdiagnosed as emotional problems, and they tend not to be properly referred for ablation at the same rate that men are, so the sample size for women is smaller.

I thought this was very astute.

______________
Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.
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Jackie
Re: Are women harder to ablate?
June 06, 2013 03:58PM
Barb - I believe that trefers to the overall structural size difference in gender and I thought at one time Dr. Natale was quoted as saying a female heart might be slighly more challenging. However in the hands of elite EPs, it should not be an issue

[www.ncbi.nlm.nih.gov]

I have a reference to a study, but don't have a formal link to it.

Pham TV, Rosen MR. Sex-differences in electrophysiology of the heart and cardiac arrhythmias. Adv Mol Cell Biol 34: 115–130, 2004.

Jackie
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Iatrogenia
Re: Are women harder to ablate?
June 06, 2013 04:04PM
Dr. Hao said the size of my heart wouldn't be a problem, and I'm a small woman.

______________
Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.
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tobherd
Re: Are women harder to ablate?
June 06, 2013 11:07PM
Well Ok then - that's good to hear. I'm not a tiny - or very big person, but was wondering if I had heard that correctly. I'm going to assume Dr. Natale has worked on quite a few women so far, so it won't affect the outcome even if this were true...

Barb
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dwightsbride
Re: Are women harder to ablate?
June 07, 2013 09:40PM
My EP told me that women tend to have more problems with ablations--said their hearts were thinner, whatever that means.
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Shannon
Re: Are women harder to ablate?
June 09, 2013 12:39PM
It's not an issue to be concerned about at all Barb. All the top EPs with at least several thousand ablations under their belt have all ablated large numbers of women successfully. Dr. N has successfully ablated more women than most other high skilled EPs have ablated in total both men and women, so you are in the right place in any event.

Shannon
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Tom in Hawaii
Re: Are women harder to ablate?
June 09, 2013 04:04PM
Shannon, I answered your email.

Tom
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Shannon
Re: Are women harder to ablate?
June 11, 2013 10:02AM
Many thanks Tom,

I just got your reply after returning home from San Diego where we were for the last week, and will reply on my computer today (Tuesday) where I can type on a real keyboard.
All the best,
Shannon
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researcher
Re: Are women harder to ablate?
June 12, 2013 09:30AM
There have been a number of papers showing that bleeding complications are higher for women so this is something to discuss with your EP about their specific experience and what they do to minimize complications. Intuitively, there will be a size effect. That is why pediatric ablations get referred to specialized centers with the proper equipment and training.
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