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 .
Apixaban versus warfarin in patients with atrial fibrillation.
BACKGROUND Vitamin K antagonists are highly effective in preventing stroke in patients with atrial fibrillation but have several limitations . Apixaban is a novel oral direct factor Xa inhibitor that has been shown to reduce the risk of stroke in a similar population in comparison with aspirin . METHODS In this r and omized , double-blind trial , we compared apixaban ( at a dose of 5 mg twice daily ) with warfarin ( target international normalized ratio , 2.0 to 3.0 ) in 18,201 patients with atrial fibrillation and at least one additional risk factor for stroke . The primary outcome was ischemic or hemorrhagic stroke or systemic embolism . The trial was design ed to test for noninferiority , with key secondary objectives of testing for superiority with respect to the primary outcome and to the rates of major bleeding and death from any cause . RESULTS The median duration of follow-up was 1.8 years . The rate of the primary outcome was 1.27 % per year in the apixaban group , as compared with 1.60 % per year in the warfarin group ( hazard ratio with apixaban , 0.79 ; 95 % confidence interval [ CI ] , 0.66 to 0.95 ; P<0.001 for noninferiority ; P=0.01 for superiority ) . The rate of major bleeding was 2.13 % per year in the apixaban group , as compared with 3.09 % per year in the warfarin group ( hazard ratio , 0.69 ; 95 % CI , 0.60 to 0.80 ; P<0.001 ) , and the rates of death from any cause were 3.52 % and 3.94 % , respectively ( hazard ratio , 0.89 ; 95 % CI , 0.80 to 0.99 ; P=0.047 ) . The rate of hemorrhagic stroke was 0.24 % per year in the apixaban group , as compared with 0.47 % per year in the warfarin group ( hazard ratio , 0.51 ; 95 % CI , 0.35 to 0.75 ; P<0.001 ) , and the rate of ischemic or uncertain type of stroke was 0.97 % per year in the apixaban group and 1.05 % per year in the warfarin group ( hazard ratio , 0.92 ; 95 % CI , 0.74 to 1.13 ; P=0.42 ) . CONCLUSIONS In patients with atrial fibrillation , apixaban was superior to warfarin in preventing stroke or systemic embolism , caused less bleeding , and result ed in lower mortality . ( Funded by Bristol-Myers Squibb and Pfizer ; ARISTOTLE Clinical Trials.gov number , NCT00412984 . )
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 .