{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:03:14Z","timestamp":1793811794010,"version":"4.6.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The outcomes of atrial fibrillation (AF) seem to be variable between males and females. We therefore aimed to determine sex differences in weight loss, cardiorespiratory fitness gain, and recurrence and progression of AF following risk factor management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>\n              Of 1415 consecutive patients referred for electrophysiology management of AF, 825 had a body mass index of \u226527 kg\/m\n              <jats:sup>2<\/jats:sup>\n              ; after exclusions, 355 (males, 234; females, 121) were offered risk factor management and participation in a tailored exercise program.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Females were older than males (65.5\u00b110.4 versus 62.5\u00b110.6 years;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.013) with a higher body mass index (34.1\u00b15.4 versus 32.6\u00b14.1 kg\/m\n              <jats:sup>2<\/jats:sup>\n              ;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.003) and more commonly paroxysmal AF (67.8% versus 48.3%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001). There was no sex difference in clinic attendance (58.7% versus 60%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.82), weight loss (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.86), fitness gain (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.44), or improvement in AF symptoms (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.35). Weight loss (\u226510% compared with &lt;10%) was associated with lower total AF recurrence in males (hazard ratio, 0.41 [95% CI, 0.23\u20130.73]) and females (hazard ratio, 0.41 [95% CI, 0.20\u20130.83]). Fitness gain (\u22652 metabolic equivalents compared with &lt;2 metabolic equivalents) was associated with lower total AF recurrence in females (hazard ratio, 0.13 [95% CI, 0.05\u20130.30]) but not in males (hazard ratio, 0.63 [95% CI, 0.38\u20131.04];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.002). There was a trend toward more reversal from persistent to paroxysmal AF in males compared with females (21.8% versus 14.0%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.079).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Males and females with AF demonstrate a similar degree of weight loss and fitness gain through structured risk factor management. However, fitness had a much greater benefit for total arrhythmia recurrence in females compared with males, whereas there was a trend toward more AF reversal in males.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/anzctr.org.au\">https:\/\/anzctr.org.au<\/jats:ext-link>\n              ; Unique identifier: ACTRN12614001123639.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.123.012534","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T09:01:08Z","timestamp":1718701268000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Sex Differences in Outcomes of an Intensive Risk Factor Modification Program in Patients With Atrial Fibrillation"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"actrn12614001123639","registry":"10.18810\/anzctr"}],"author":[{"given":"Jean Jacques","family":"Noubiap","sequence":"first","affiliation":[{"name":"Centre for Heart Rhythm Disorders, University of Adelaide, Australia (J.J.N., R.K.P., G.T., A.D.E., P.S., M.E.M.)."},{"name":"Division of Cardiology, Department of Medicine, University of California-San Francisco (J.J.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7391-6867","authenticated-orcid":true,"given":"Rajeev K.","family":"Pathak","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders, University of Adelaide, Australia (J.J.N., R.K.P., G.T., A.D.E., P.S., M.E.M.)."},{"name":"Australian National University &amp; Canberra Heart Rhythm, Australia (R.K.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gijo","family":"Thomas","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders, University of Adelaide, Australia (J.J.N., R.K.P., G.T., A.D.E., P.S., M.E.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5951-4239","authenticated-orcid":true,"given":"Adrian D.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders, University of Adelaide, Australia (J.J.N., R.K.P., G.T., A.D.E., P.S., M.E.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3803-8429","authenticated-orcid":true,"given":"Prashanthan","family":"Sanders","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders, University of Adelaide, Australia (J.J.N., R.K.P., G.T., A.D.E., P.S., M.E.M.)."},{"name":"Department of Cardiology, Royal Adelaide Hospital, Australia (P.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa E.","family":"Middeldorp","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders, University of Adelaide, Australia (J.J.N., R.K.P., G.T., A.D.E., P.S., M.E.M.)."},{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.E.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493019897870"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-022-00820-8"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000748"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.09.028"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.03.002"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euy117"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.488"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61774-8"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.1314"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028981"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.185649"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960130809"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.08.003"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.11.054"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(00)00886-x"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcab096"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.06.029"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz179"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2016.04.014"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1159\/000362196"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12241"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1159\/000512294"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvab028"},{"key":"e_1_3_3_26_2","volume-title":"Exercise Physiology: Human Bioenergetics and Its Applications","author":"Brooks GA","year":"1996","unstructured":"Brooks, GA, Fahey, TD, White, TP. 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