Introduction:
Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. The lifetime risk of developing AF in a 55-year-old person is as high as 40%.[1] Thromboembolism-associated stroke is the most feared complication of AF.[2] In AF patients, the risk of stroke increases by 4-fold in men and 5.7-fold in women.[3] Percutaneous left atrial appendage closure (pLAAC) is a novel technique for stroke prevention in patients with AF who are not suitable candidates for long-term anticoagulation.[4]
Multiple prior studies have reported significant gender differences in risk of AF and antecedent stroke risk, with women at a considerably higher risk of stroke and hospital admissions.[5, 6] Initial European experience with pLAAC showed women were at higher risk of cardiac tamponade/pericardial effusion.[7] The pivotal trials leading to the approval of pLAAC were not powered to compare gender-specific differences rigorously. [8, 9] The National Cardiovascular LAAO Registry reported increased rates of major complications in women at the time of implantation; however, short-term risk thereafter remains unknown.[10] Therefore, we aim to study gender differences in peri-procedural and readmissions outcomes in patients undergoing pLAAC.