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Gender differences in atrial fibrillation: patient-reported outcomes beyond symptom management alone
  1. Jeroen Hendriks1,2,
  2. Anna Strömberg2
  1. 1 Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, The University of Adelaide and the Royal Adelaide Hospital-North Terrace Campus, Adelaide, South Australia, Australia
  2. 2 Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  1. Correspondence to Dr Jeroen Hendriks, Centre for Heart Rhythm Disorders, University of Adelaide, Adelaide 5000, Australia; jeroen.hendriks{at}adelaide.edu.au

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Healthcare aims to provide comprehensive care that is equitable, evidence-based and person-centred for all patients. However, it is well known that cardiovascular health disparities exist in relation to gender. Significant differences have been reported in major cardiovascular conditions such as heart failure and coronary artery disease to the prejudice of women, including underrecognition of symptoms, underrepresentation in clinical trials and the provided treatment not according to evidence-based standards. At the same time, women are experiencing a lower quality of life and more symptoms of anxiety and depression compared with men. However, with the paradox of women, especially in the heart failure population, demonstrating better survival. Evidence in atrial fibrillation (AF) reports similar conclusions, demonstrating underrecognition of symptoms and disparities in treatment options such that rhythm control strategies will less likely be applied in women compared with men.1 AF being considered the most prevalent heart rhythm disorder, however, can potentially cause significant symptoms requiring application of rate and/or rhythm control strategies in patients.

Clinical symptoms are key in therapeutic decision making; symptoms may trigger patients to contact or visit a healthcare professional for diagnostic check-up, and pharmaceutical or interventional treatment is often based on the symptoms expressed by the patient. This is often the case in the management of AF. The European Society of Cardiology (ESC) guidelines for the management of AF state that rate and rhythm controlling strategies are provided aiming to improve symptoms.2 Although the burden of …

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