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Hi Nolan and Kyla,

You did a fantastic job managing the discussion last week, Kyla, and your summary of the MGR presented the important points in an understandable, engaging way!

Nolan, this is a really interesting topic, so I did some searching to see whether treatment for atrial fibrillation (AF) accounts for sex differences. As we talked about in the discussion, AF is treated with rate or rhythm control. Large observational cohort studies found that women had more complications related to adverse effects of antiarrhythmic drugs. This might be because healthy women tend to have longer QT intervals, and many antiarrhythmic medications prolong the QT interval. Women treated with various antiarrhythmic drugs, including sotalol and dofetilide, were more likely to develop torsades de pointes (a type of ventricular tachycardia seen in those with a long QT interval). Female patients being less able to tolerate these antiarrhythmic drugs is may be a reason why female patients treated with antiarrhythmic are less likely to return to sinus rhythm and have more AF hospitalizations (1).

We also discussed anticoagulant drugs for the treatment of perioperative AF. There is less evidence for sex differences in outcomes for patients receiving anticoagulants. Some studies have found that men experience more anticoagulation, while others have not. However, risk of stroke or embolism is similar between men and women prescribed direct oral anticoagulants (1).

I look forward to hearing your thoughts and thank you again Kyla!


1. Westerman S, Wenger N. Gender Differences in Atrial Fibrillation: A Review of Epidemiology, Management, and Outcomes. Curr Cardiol Rev. 2019;15(2):136-144. doi: 10.2174/1573403X15666181205110624. PMID: 30516110; PMCID: PMC6520576.

Samantha Ables

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