ArticleEuropean heart journal2026
Sex differences in atrial fibrillation-related atrial remodelling assessed by electroanatomic mapping and biopsy.
Article in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sex-based disparities in postoperative outcomes after catheter ablation for atrial fibrillation: a systematic review and meta-analysis of propensity-matched studies.BMC cardiovascular disorders · 2026Pooled it
- Atrial fibrillation among women in endurance sports: sex-specific risk and mechanisms.European journal of applied physiology · 2026Review
- Understanding the Diseased Atria.Physiology (Bethesda, Md.) · 2026Review
- Sex-specific assumptions underlie cardiovascular digital twin technologies: A narrative review.PLOS digital health · 2026Review
- Atrial Cardiomyopathy and Atrial Fibrillation: Insight From Histopathological Analysis of Atrial Biopsies.Korean circulation journal · 2026Review
- Head-to-head comparison of non-invasive markers of atrial cardiomyopathy and their association with arrhythmia recurrence after atrial fibrillation ablation.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Comparative cardiac electrophysiological analysis between sinus rhythm and atrial fibrillation: The correlation of left atrial low-voltage substrate of sex and rhythm.Heart rhythm O2 · 2026Article
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Authors and funding
21 authors.
Funding
Abstract
BACKGROUND AND
aimsHistopathological sex differences in atrial structural remodelling in patients with non-valvular atrial fibrillation (AF) require further investigation.
methodsRight atrial biopsy was performed on 282 patients undergoing AF ablation and high-density voltage mapping (66 ± 12 years; 81 women). Of the 58 patients without AF undergoing supraventricular tachycardia ablation included, 26 underwent atrial biopsy and 41 underwent voltage mapping. The voltage at the biopsy site (Vbiopsy), global left atrial voltage (VGLA), and histopathological parameters (fibrosis, intercellular space, myofibrillar loss, myocardial nuclear density, and cardiomyocyte diameter) were evaluated.
resultsVbiopsy (7.4 ± 2.6 vs 9.3 ± 3.2 mV, P < .001) and VGLA (4.9 ± 1.8 vs 6.7 ± 2.2 mV, P < .001) were significantly lower in women with AF. A similar relationship was observed in patients without AF: Vbiopsy (7.8 ± 2.7 vs 10.9 ± 2.6 mV, P < .001) and VGLA (7.3 ± 1.7 vs 9.4 ± 1.4 mV, P < .001) were lower in women. Vbiopsy and VGLA positively correlated in both groups (r = 0.70 and 0.60, P < .001), supporting an integrated interpretation of the voltage and histopathological data. No significant sex differences were observed among the histopathological parameters. In 34 patients with minimal histological change, small cardiomyocytes (<10 μm) were more frequent in women (37% ± 23% vs 20% ± 19%, P = .029).
conclusionsDespite consistently lower voltage in women, no significant histopathological sex differences were identified in non-valvular cases, likely due to their inherently smaller atrial mass.
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