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J Womens Health (Larchmt). 2015 Jun;24(6):466-70. doi: 10.1089/jwh.2014.5014. Epub 2015 May 15.

Gender Differences in Patients with Atrial Fibrillation Undergoing Electrical Cardioversion.

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  • 11 Grup de Recerca Cardiovascular, Hospital Universitari de Sant Joan, IISPV, Universitat Rovira i Virgili , Reus, Spain .
  • 22 Hospital de la Sta. Creu i St. Pau , Barcelona, Spain .
  • 33 Hospital Universitari Parc Taulí , Sabadell, Spain .
  • 44 Hospital Universitario Virgen del Rocío , Sevilla, Spain .
  • 55 Complejo Hospitalario Universitario de Vigo , Vigo, Spain .
  • 66 Hospital General de Albacete , Albacete, Spain .
  • 77 Hospital Lucus Augusti , Lugo, Spain .
  • 88 Hospital Costa del Sol , Marbella, Spain .



Current recommendations on the rhythm control strategy for treatment of atrial fibrillation (AF) are more restrictive than a decade ago. Gender may play a role in decisions on the management of AF, including application of electrical cardioversion.


We analyzed clinical characteristics by gender in patients participating in the observational survey about stable patients underlying cardioversion in Spain (CARDIOVERSE) study (n=915), a survey of the practice of electrical cardioversion in 67 Spanish hospitals. We compared these data with those from a previous survey of electrical cardioversion in Spain (REVERSE study) performed 8 years previously.


Patients undergoing electrical cardioversion were mainly men (76%). This finding was observed in all age groups, independently of symptoms. Men were younger (62±10 years vs. 69±9 years; p<0.001), more frequently asymptomatic and had a lower prevalence of hypertension and a lower stroke risk. Among asymptomatic patients, the predominance of men was especially evident in older age groups (<65 years, men 76%, women 24%; ≥65 years, men 92%, women 8% (p<0.001). Compared with the REVERSE study, we observed a decrease in the percentage of women among patients undergoing electrical cardioversion (37% REVERSE vs. 24% CARDIOVERSE; p<0.001), mainly in older than 65 years.


Our results support the hypothesis that gender is a determinant in decisions on the most appropriate strategy for managing AF. We observed a decrease in the percentage of women undergoing electrical cardioversion during the last decade, especially in older asymptomatic patients.

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