Catheter ablation of atrial fibrillation in patients with diabetes mellitus.
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2020-08
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Abstract
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.Type
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Wang, Allen, Tracy Truong, Eric Black-Maier, Cynthia Green, Kristen B Campbell, Adam S Barnett, Janice Febre, Zak Loring, et al. (2020). Catheter ablation of atrial fibrillation in patients with diabetes mellitus. Heart rhythm O2, 1(3). pp. 180–188. 10.1016/j.hroo.2020.04.006 Retrieved from https://hdl.handle.net/10161/25526.
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Scholars@Duke
Tracy Truong
Tracy currently collaborates with clinicians, residents, and fellows in the Department of Obstetrics and Gynecology, Neurology, Pediatrics, and Center for Childhood Obesity Research. Her professional experience includes data management, observational studies, with an emphasis on reproducible research utilizing R markdown.
Camille Genise Frazier
Donald Dale Hegland
Kevin Patrick Jackson
Research interests include:
- optimization of device timing for Cardiac Resynchronzation Therapy (CRT)
- novel cardiac imaging technologies for CRT
- catheter ablation versus anti-arrhythmic drug for treatment of atrial fibrillation.
Jason Koontz
Albert Y. Sun
Kevin Lindsey Thomas
Tristram Dan Bahnson
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.