Study finds significant health disparities for women with atrial fibrillation

A new study found concerning disparities for women living with a heart condition called atrial fibrillation.

An active lifestyle filled with golf, swimming, Pilates and caring for four grandchildren keeps 81-year-old Deirdre Cowan busy. But three years ago, a stroke brought her routine to an abrupt halt. She later learned she had been living with atrial fibrillation, a condition that causes an irregular heartbeat through misfiring of electrical signals.

"I'd be resting or sleeping, and all of a sudden my heart would really hurt me," Cowan said.

Atrial fibrillation, also known as AFib, is the most common type of irregular heartbeat. The condition significantly increases the risk of stroke and dementia.

After two recent trips to the emergency room, Cowan underwent catheter ablation at Northwell Health's Lenox Hill Hospital three weeks ago. 

"We try to insulate the areas of the heart that generate the abnormal electrical signal," said Dr. Stavros Mountantonakis, Cowan's surgeon and director of electrophysiology (EP) at Lenox Hill Hospital. "Multiple studies have shown that it's superior to any medication." 

Mountantonakis was also a researcher on a new Northwell Health study that followed 165,000 patients over several years, uncovering a significant disparity in how men and women are treated for the condition.

"For every three men that end up in our EP laboratory, we ablate two women, so the question was why women end up having this procedure way less often than men," Mountantonakis said.

The gap is particularly concerning because research shows that atrial fibrillation affects men and women at relatively similar rates.

Mountantonakis said several factors may help explain the disparity.

"We think that the presentation in women is a little different than men," he said.

Many women are diagnosed around perimenopause, when symptoms associated with hormonal changes can resemble those of atrial fibrillation, he said. 

"Women don't complain as much," Mountantonakis said. "They're used to taking care of others, so they're less likely to self-report to their cardiologist with symptoms."

He believes the findings could help reshape how the medical community approaches the condition.

"Most of the studies that are out there on established current medical care are based on studying men. So this is something that we're changing, both in nationwide, but also specifically here at Northwell," he said.

For Cowan, recovery has brought a renewed desire to preserve her quality of life.

"It's a tremendous relief because I enjoy my life," she said.

She has resumed her exercise routine and is planning a trip to her native Australia later this month to spend time with her grandchildren.

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