Catheter ablation of atrial fibrillation in patients with diabetes mellitus.

Journal Article (Journal Article)

BACKGROUND: Diabetes mellitus (DM) is an independent risk factor for atrial fibrillation (AF). Few studies have compared clinical outcomes after catheter ablation between patients with and those without DM. OBJECTIVE: The purpose of this study was to compare AF ablation outcomes in patients with and those without DM. METHODS: We performed a retrospective analysis of 351 consecutive patients who underwent first-time AF ablation. Clinical outcomes included freedom from recurrent atrial arrhythmia, symptom burden (Mayo AF Symptom Inventory score), cardiovascular and all-cause hospitalizations, and periprocedural complications. RESULTS: Patients with DM (n = 65) were older, had a higher body mass index, more persistent AF, more hypertension, and larger left atrial diameter (P <.05 for all). Median (Q1, Q3) total radiofrequency duration [64.0 (43.6, 81.4) minutes vs 54.3 (39.2, 76.4) minutes; P = .132] and periprocedural complications (P = .868) did not differ between patients with and those without DM. After a median follow-up of 29.5 months, arrhythmia recurrence was significantly higher in the DM group compared to the no-DM group after adjustment for baseline differences (adjusted hazard ratio [HR] 2.24; 95% confidence [CI] 1.42-3.55; P = .001). There was a nonsignificant trend toward higher AF recurrence with worse glycemic levels (HR 1.29; 95% CI 0.99-1.69; P = .064). CONCLUSION: Although safety outcomes associated with AF ablation were similar between patients with and those without DM, arrhythmia-free survival was significantly lower among patients with DM. Poor glycemic control seems to an important risk factor for AF recurrence.

Full Text

Duke Authors

Cited Authors

  • Wang, A; Truong, T; Black-Maier, E; Green, C; Campbell, KB; Barnett, AS; Febre, J; Loring, Z; Al-Khatib, SM; Atwater, BD; Daubert, JP; Frazier-Mills, C; Hegland, DD; Jackson, KP; Jackson, LR; Koontz, JI; Lewis, RK; Pokorney, SD; Sun, AY; Thomas, KL; Bahnson, TD; Piccini, JP

Published Date

  • August 2020

Published In

Volume / Issue

  • 1 / 3

Start / End Page

  • 180 - 188

PubMed ID

  • 34113872

Pubmed Central ID

  • PMC8183889

Electronic International Standard Serial Number (EISSN)

  • 2666-5018

Digital Object Identifier (DOI)

  • 10.1016/j.hroo.2020.04.006


  • eng

Conference Location

  • United States