In brief , female atrial fibrillation patients more commonly present comorbidities , leading to a higher prevalence of persistent atrial fibrillation ; moreover , they refer to hospital care later and with a longer disease history .
Atrial fibrillation symptoms relate to low quality of life in female patients ; in fact , atrial fibrillation paroxysm usually presents higher heart rate , leading to preferentially adopt a rate rather than a rhythm-control strategy .
Female atrial fibrillation patients present an increased risk of stroke , worsened by the lower  oral anticoagulant prescription rate related to the concomitant higher haemorrhagic risk profile .
Trans-catheter ablation is under-used in female patients and , on the contrary , they are more commonly affected by anti-arrhythmic drug side effects
Atrial fibrillation is the most common supraventricular arrhythmia .
Its prevalence increases with age and preferentially affects male patients .
Over 75 years of age , however , female patients being more prevalent , the absolute number of patients affected is similar between sexes .
Despite this , few data are available in the literature concerning sex-related differences in atrial fibrillation patients .
The present systematic review therefore considers comorbidities , referring symptoms , quality of life , pharmacological approaches  and  trans-catheter ablation  in female rather than in male atrial fibrillation patients in search of parameters that may have an impact on the treatment outcome .
Gender differences in stroke risk of atrial fibrillation patients on oral anticoagulant treatment.
The efficacy of adjusted-dose oral anticoagulant treatment ( OAT ) in the prevention of stroke in atrial fibrillation ( AF ) is well documented . Available data show that AF patients are widely heterogeneous in terms of ischaemic stroke risk . The role of female gender as a predictor of stroke risk is inconsistent , in particular it is unclear if warfarin treatment is able to prevent stroke equally in both sexes . We performed a prospect i ve study on 780 AF patients on OAT , followed by an Anticoagulation Clinic , to evaluate if female gender is a risk factor for stroke among patients on OAT  and if the quality of anticoagulation is different between genders . No difference was found in relation to the quality of anticoagulation between genders ( p=0.5 ) . During follow-up 33 patients had major bleedings ( rate 1.37 x 100 pt/yrs ) but no difference was found between genders in bleeding risk . Forty patients had ischaemic events [ rate 1.66 x 100 pt/yrs ; males rate 1.2 x 100 pt/yrs ; females rate 2.43 x 100 pt/yrs ; p=0.042 ; relative risk ( RR ) of females vs. males 2.0 ( 95 % confidence interval [ CI ] 1.3 - 3.1 ) ; p= 0.004 ] . The higher rate of ischaemic events in females with respect to males was confirmed at Cox regression analysis after correction for age ( p=0.009 ) . In addition , strokes occurring in females were more disabling , and RR for severe and fatal stroke , defined according to Modified Rankin scale , of females vs. males was 3.1 ( 95 % CI 1.3 - 6.5 ; p=0.001 ) . In conclusion , our data show a higher risk of stroke in anticoagulated AF females with respect to males , despite a similar quality of anticoagulation
In brief , female atrial fibrillation patients more commonly present comorbidities , leading to a higher prevalence of persistent atrial fibrillation ; moreover , they refer to hospital care later and with a longer disease history .
Atrial fibrillation symptoms relate to low quality of life in female patients ; in fact , atrial fibrillation paroxysm usually presents higher heart rate , leading to preferentially adopt a rate rather than a rhythm-control strategy .
Female atrial fibrillation patients present an increased risk of stroke , worsened by the lower  oral anticoagulant prescription rate related to the concomitant higher haemorrhagic risk profile .
Trans-catheter ablation is under-used in female patients and , on the contrary , they are more commonly affected by anti-arrhythmic drug side effects
Atrial fibrillation is the most common supraventricular arrhythmia .
Its prevalence increases with age and preferentially affects male patients .
Over 75 years of age , however , female patients being more prevalent , the absolute number of patients affected is similar between sexes .
Despite this , few data are available in the literature concerning sex-related differences in atrial fibrillation patients .
The present systematic review therefore considers comorbidities , referring symptoms , quality of life , pharmacological approaches  and  trans-catheter ablation  in female rather than in male atrial fibrillation patients in search of parameters that may have an impact on the treatment outcome .