Sex Differences in Atrial Fibrillation and Its Complications

Atrial fibrillation (AF) is the most common arrhythmia in the general population, and several studies predict a significant increase in the incidence of AF during the next decades. This review examines gender differences in the AF epidemiology, risk factors associated with AF, and gender differences in the presentation, management, and outcome of AF. In every age group, AF is less frequent in women than in men. However, the absolute number of AF cases is similar in men and women due to women’s longer lifespan. Women are more symptomatic when AF occurs, and episodes are associated with higher heart rates. Women with AF are more likely to develop stroke than men. Anticoagulants are less frequently used in women although women seem to receive a similar benefit. Studies suggest that women are referred to interventional therapies later than men and often with a more complex presentation.