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Diabetes mellitus ups arrhythmia recurrence after catheter ablation

23 Mar 2020

Catheter ablation of atrial fibrillation (AF) appears to be safe for patients with diabetes mellitus (DM), a recent study has found. However, DM increases the rate of relapse of atrial arrhythmia, particularly in those with persistent AF.

The study included 2,504 patients who had undergone catheter ablation. Of these, 234 (mean age, 63.9±7.5 years; 71 percent female) were DM patients and 2,270 (mean age, 60.8±10.4 years; 66.5 percent female) were not. Procedural outcomes, such as freedom from atrial arrhythmia within 3 months and vascular complications, were compared between subgroups.

DM patients had significantly more relapses during the following 12 months than their non-DM counterparts (25.3 percent vs 32.0 percent; p=0.031). Adjusting for the type of AF, researchers also found that the atrial arrhythmia-free survival during a median follow-up of 17 months after the ablation of persistent AF was significantly lower in diabetics (log-rank p=0.003).

In contrast, no such group difference in arrhythmia-free survival was found after the ablation of paroxysmal AF (log-rank p=0.554).

This was confirmed by multivariate Cox regression analysis, which found DM as a significant and independent predictor of AF or arrhythmia relapse (hazard ratio [HR], 1.39, 95 percent confidence interval [CI], 1.07–1.82; p=0.016). This was also true for AF duration (HR, 1.02, 95 percent CI, 1.01–1.04; p<0.001) and left atrial volume (HR, 1.01, 95 percent CI, 1.00–1.01; p<0.001).

Peri-procedural complications, on the other hand, occurred with comparable frequencies between the DM and non-DM groups (p=0.128).

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