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 .
Sex differences in the relationship between amiodarone use and the need for permanent pacing in patients with atrial fibrillation.
BACKGROUND Amiodarone use was associated with an increased need for pacemaker insertion in a retrospective study of patients with atrial fibrillation ( AF ) and prior myocardial infa rct ion . The aims of this study were to determine prospect ively whether amiodarone increases the need for pacemakers in a general population of patients with AF and whether this effect is modified by sex . METHODS The study included 1005 patients with new-onset AF who were enrolled in the Fibrillation Registry Assessing Costs , Therapies , Adverse events , and Lifestyle ( FRACTAL ) .  Multivariable Cox regression models , including time-dependent covariates accounting for medication exposure , were used to evaluate the risk of pacemaker insertion associated with amiodarone use . RESULTS Amiodarone use was associated with an increased risk of pacemaker insertion ( hazard ratio [ HR ] , 2.01 ; 95 % confidence interval [ CI ] , 1.08 - 3.76 ) after adjustment for age , sex , atrial flutter , coronary artery disease , heart failure , and hypertension . The effect of amiodarone use was modified by sex , with a significant risk in women but not in men ( HR , 4.69 ; 95 % CI , 1.99 - 11.05 vs HR , 1.05 ; 95 % CI , 0.42 - 2.58 [ P = .02 ] ) . This interaction remained significant after adjustment for weight , body mass index , weight-adjusted amiodarone dose , and use of other antiarrhythmic or rate control drugs . CONCLUSION The risk of bradyarrhythmia requiring pacemaker insertion associated with amiodarone use for AF is significantly greater in women than in men , independent of weight or body mass index
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 .