Gender differences in accessory connections location: An Israeli study

Background Recent studies have shown that the pathogenesis of accessory connections (AC) formation may have a genetic component. Objective The purpose of the study was to examine whether AC location differs by gender in a large cohort of patients with AC undergoing radiofrequency ablation (RFA) in two Israeli electrophysiology (EP) laboratories. Methods All consecutive patients who underwent RFA of single ACs in Tel Aviv Sourasky Medical Center between 1992 and 2009 (n0574) as well as the first consecutive 230 patients who underwent RFA in Sheba Medical Center between 1992 and 2001 were included in this study. Results The 804 patients in the two centers included 511 males (63.6 %) and 293 (36.4 %) females, mean age 34+ 16 years old. The AC was located in the left free wall, posteroseptal, right free wall, right anteroseptal, and in other areas in 57.8, 22.8, 9.3, 7 and 3.1 % of patients, respectively. The anatomical AC distribution was similar in the two EP laboratories. A right free wall location was more frequent in females (13 %) than in males (7.2 %; p00.008). A right anteroseptal location was more frequent in males (8.4 %) than in females (4.4 %) (p00.043). The left free wall and posteroseptal locations were similarly encountered in males (58.1 and 23.1 %, respectively) and in females (57.3 and 22.2 %, respectively). Conclusions In our Israeli population, females more commonly have right free wall ACs and males more commonly have right anteroseptal ACs. These findings support the possible role of a genetic component in the pathogenesis of AC formation.