{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:05:15Z","timestamp":1788998715098,"version":"build-2803163510"},"reference-count":107,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Atrial fibrillation (AF) is the most common sustained arrhythmia associated with increased risks of stroke, heart failure, and mortality. Men experience AF more frequently than women, but women are more likely to suffer greater symptoms and reduced quality of life as a consequence of AF onset. Its pathophysiology is complex, influenced by hormonal, structural, electrophysiological, and genetic factors. Sex hormones, including oestrogen, progesterone, and testosterone, play critical roles in modulating cardiac electrophysiology, autonomic function, and atrial remodelling, contributing to sex\u2010specific differences in AF prevalence and outcomes. Women experience increased AF risk post\u2010menopause due to declining oestrogen levels, while testosterone fluctuations in men are associated with arrhythmogenesis. Thyroid hormones further complicate the hormonal landscape by influencing cardiac excitability and autonomic regulation. Electrophysiological and structural differences between sexes, such as longer P\u2010wave durations and greater fibrosis in women, result in increased AF recurrence and complications, particularly after catheter ablation. Men, however, have a higher overall AF incidence, likely due to larger atrial sizes and different conduction properties. Lifestyle and psychological factors, including obesity, physical activity, and mental health, intersect with these sex\u2010specific risks, further influencing AF susceptibility. Artificial intelligence (AI) offers transformative opportunities to integrate these factors into personalised prevention and treatment strategies, enhancing early detection and tailored interventions. This review highlights the critical role of hormonal and sex\u2010specific factors in AF pathophysiology, emphasising the need for sex\u2010specific approaches to optimise management. Understanding these mechanisms is essential for developing targeted, personalised strategies to improve outcomes for men and women with AF.<\/jats:p>","DOI":"10.1111\/jce.70063","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T08:20:21Z","timestamp":1755505221000},"page":"2608-2619","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Unravelling Sex Disparities in the Pathophysiology of Atrial Fibrillation: Review of the Current Evidence"],"prefix":"10.1111","volume":"36","author":[{"given":"Ibrahim","family":"Antoun","sequence":"first","affiliation":[{"name":"Department of Cardiology University Hospitals of Leicester NHS Trust, Glenfield Hospital Leicester UK"},{"name":"Department of Cardiovascular Sciences, Clinical Science Wing University of Leicester, Glenfield Hospital Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia R.","family":"Layton","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Clinical Science Wing University of Leicester, Glenfield Hospital Leicester UK"},{"name":"Department of Cardiac Surgery University Hospitals of Leicester NHS Trust, Glenfield Hospital Leicester UK"},{"name":"Leicester British Heart Foundation Centre of Research Excellence Glenfield Hospital Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abdelrazik","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospitals of Leicester NHS Trust, Glenfield Hospital Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Eldesouky","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospitals of Leicester NHS Trust, Glenfield Hospital Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayley","family":"Davies","sequence":"additional","affiliation":[{"name":"Department of Haematology University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Barakat","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Aleppo Aleppo Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Mahfoud","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Aleppo Aleppo Syria"},{"name":"Department of Medicine University of Latakia Latakia Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulmalik","family":"Koya","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospitals of Leicester NHS Trust, Glenfield Hospital Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward Y. 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