Catheter ablation of atrial fibrillation in patients with diabetes mellitus: a systematic review and meta-analysis
Open accessAbstract
AIMS: Diabetes mellitus (DM) and atrial fibrillation (AF) share pathophysiological links, as supported by the high prevalence of AF within DM patients. Catheter ablation of AF (AFCA) is an established therapeutic option for rhythm control in drug resistant symptomatic patients. Its efficacy and safety among patients with DM is based on small populations, and long-term outcome is unknown. The present systematic review and meta-analysis aims to assess safety and long-term outcome of AFCA in DM patients, focusing on predictors of recurrence. METHODS AND RESULTS: A systematic review was conducted in MEDLINE/PubMed and Cochrane Library. Randomized controlled trials, clinical trials, and observational studies including patients with DM undergoing AFCA were screened and included if matching inclusion and exclusion criteria. Fifteen studies were included, adding up to 1464 patients. Mean follow-up was 27 (20-33) months. Overall complication rate was 3.5 (1.5-5.0)%. Efficacy in maintaining sinus rhythm at follow-up end was 66 (58-73)%. Meta-regression analysis revealed that advanced age (P < 0.001), higher body mass index (P < 0.001), and higher basal glycated haemoglobin level (P < 0.001) related to higher incidence of arrhythmic recurrences. Performing AFCA lead to a reduction of patients requiring treatment with antiarrhythmic drugs (AADs) from 55 (46-74)% at baseline to 29 (17-41)% (P < 0.001) at follow-up end. CONCLUSIONS: Catheter ablation of AF safety and efficacy in DM patients is similar to general population, especially when performed in younger patients with satisfactory glycemic control. Catheter ablation of AF reduces the amount of patients requiring AADs, an additional benefit in this population commonly exposed to adverse effects of AF pharmacological treatments.
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Diabetes is probably not the most potent independent risk factor for stroke in atrial fibrillation compared with the other items in the CHA2DS2-VASc score.
“Diabetes is probably not the most potent independent risk factor for stroke in AF compared with the other items in the CHA 2 DS 2 -VASc score, but it is included in this risk-stratification tool, giving a point alongside most other items.600,618,[622][623][624]”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [618]
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Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823 · see citing works
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859 · see citing works
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623 · see citing works
Diagnosis and Classification of Diabetes Mellitus
American Diabetes Association (2010) · Diabetes Care · doi:10.2337/dc11-s062 · Cited by 14,019 · see citing works
2012 focused update of the ESC Guidelines for the management of atrial fibrillation
Authors Task Force Members, Camm, A. J., Lip, G. Y. H., Caterina, R. D., Savelieva, I., Atar, D., Hohnloser, S. H., Hindricks, G., Kirchhof, P. F., Bax, J. J., et al. (2012) · EP Europace · doi:10.1093/europace/eus305 · Cited by 3,814 · see citing works
Diagnosis and classification of diabetes mellitus
American Diabetes Association (2013) · Diabetes Care · doi:10.2337/dc13-s067 · Cited by 2,245 · see citing works
Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort
Pathak, R. K., Middeldorp, M. E., Meredith, M., Mehta, A. B., Mahajan, R., Wong, C. X., Twomey, D., Elliott, A. D., Kalman, J. M., Abhayaratna, W. P., et al. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.03.002 · Cited by 1,036 · see citing works
Pathak, R. K., Middeldorp, M. E., Lau, D. H., Mehta, A. B., Mahajan, R., Twomey, D., Alasady, M., Hanley, L., Antic, N. A., McEvoy, R. D., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.09.028 · Cited by 949 · cited 1× · see citing works
“Optimal glyco-metabolic control and weight reduction may, therefore, be crucial to optimize AF management(36) – 38 and enhance ablation outcomes.(39) In fact, a one point increase in basal glycated haemoglobin raised by 0.”
BackgroundSelf-citationGanesan, A. N., Shipp, N. J., Brooks, A. G., Kuklik, P., Lau, D. H., Lim, H. S., Sullivan, T., Roberts‐Thomson, K. C., & Sanders, P. (2013) · Journal of the American Heart Association · doi:10.1161/jaha.112.004549 · Cited by 800 · cited 2× · see citing works
“With the inclusion of redo procedures, the long-term SR maintenance rate improved to 66%: this result is comparable with long-term outcomes reported in general AFCA populations, which typically include patients with both their first and redo ablations.(10,30,31) The relatively large proportion (37%) of patients requir…”
ResultPappone, C., Rosanio, S., Augello, G., Gallus, G., Vicedomini, G., Mazzone, P., Gulletta, S., Gugliotta, F., Pappone, A., Santinelli, V., et al. (2003) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(03)00577-1 · Cited by 779 · see citing works
Self-citationAbed, H. S., Wittert, G. A., Leong, D. P., Shirazi, M. G., Bahrami, B., Middeldorp, M. E., Lorimer, M. F., Lau, D. H., Antic, N. A., Brooks, A. G., et al. (2013) · JAMA · doi:10.1001/jama.2013.280521 · Cited by 776 · see citing works
Catheter Ablation for Atrial Fibrillation
Weerasooriya, R., Khairy, P., Litalien, J., Macle, L., Hocini, M., Sacher, F., Lellouche, N., Knecht, S., Wright, M. J., Nault, I., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.05.061 · Cited by 735 · see citing works
Self-citationHuxley, R., Filion, K. B., Konety, S., & Alonso, Á. (2011) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.03.004 · Cited by 566 · see citing works
Bunch, T. J., Crandall, B. G., Weiss, J. P., May, H. T., Bair, T. L., Osborn, J. S., Anderson, J. L., Muhlestein, J. B., Horne, B. D., LAPPE, D. L., et al. (2011) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2011.02035.x · Cited by 398 · see citing works
Self-citationWilczynski, N. L., Haynes, R. B., & the Hedges Team (2004) · BMC Medicine · doi:10.1186/1741-7015-2-23 · Cited by 291 · see citing works
Du, X., Ninomiya, T., de Galan, B., Abadir, E., Chalmers, J., Pillai, A., Woodward, M., Cooper, M., Harrap, S., Hamet, P., et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp055 · Cited by 239 · see citing works
From Selective Parasympathetic Modulation of AV Node to Rate Control Therapy
Billette, J., & Lavallée, M. (2005) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2005.00271.x · Cited by 222 · see citing works
D’Ascenzo, F., Corleto, A., Biondi‐Zoccai, G., Anselmino, M., Ferraris, F., Biase, L. D., Natale, A., Hunter, R. J., SCHILLING, R. J., Miyazaki, S., et al. (2012) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.05.008 · Cited by 216 · see citing works
Self-citationArbelo, E., Brugada, J., Hindricks, G., Maggioni, A. P., Tavazzi, L., Vardas, P., Laroche, C., Anselme, F., Inama, G., Jais, P., et al. (2014) · European Heart Journal · doi:10.1093/eurheartj/ehu001 · Cited by 212 · see citing works
Self-citationGaïta, F., Caponi, D., Scaglione, M., Montefusco, A., Corleto, A., Monte, F. D., Coin, D., Donna, P. D., & Giustetto, C. (2008) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.108.774885 · Cited by 211 · see citing works
Hunter, R. J., McCready, J., Diab, I., Page, S. P., Finlay, M., Richmond, L., French, A., Earley, M. J., Sporton, S., Jones, M., et al. (2012) · Heart · doi:10.1136/heartjnl-2011-300720 · Cited by 183 · see citing works
FORLEO, G. B., MANTICA, M., DE LUCA, L., LEO, R., SANTINI, L., PANIGADA, S., DE SANCTIS, V., PAPPALARDO, A., LAURENZI, F., AVELLA, A., et al. (2009) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2008.01275.x · Cited by 165 · see citing works
Long-Term Outcomes After Cryoballoon Pulmonary Vein Isolation
Vogt, J., Heintze, J., Gutleben, K. J., Muntean, B. G., Horstkotte, D., & Nölker, G. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.09.033 · Cited by 152 · see citing works
Pulmonary Vein Antral Isolation for Paroxysmal Atrial Fibrillation: Results from Long-Term Follow-Up
MEDI, C., SPARKS, P. B., Morton, J. B., Kistler, P. M., Halloran, K. M., Rosso, R., Vohra, J. K., Kumar, S., & Kalman, J. M. (2010) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2010.01885.x · Cited by 151 · see citing works
Self-citationChao, T., Suenari, K., Chang, S., Lin, Y., Lo, L., Hu, Y., Tuan, T., TAI, C., Tsao, H.-M., Li, C.-H., et al. (2010) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2010.07.038 · Cited by 131 · see citing works
Arbelo, E., Brugada, J., Hindricks, G., Maggioni, A. P., Tavazzi, L., Vardas, P. E., Anselme, F., Inama, G., Jaı̈s, P., Kalarus, Z. F., et al. (2012) · EP Europace · doi:10.1093/europace/eus153 · Cited by 125 · see citing works
Radiofrequency Catheter Ablation and Antiarrhythmic Drug Therapy
Pappone, C., Vicedomini, G., Augello, G., Manguso, F., Saviano, M., Baldi, M., Petretta, A., Giannelli, L., Ćalović, Ž., Guluta, V., et al. (2011) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.111.966408 · Cited by 113 · see citing works
Self-citationPotpara, T., Polovina, M. M., Marinković, J., & Lip, G. Y. H. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.07.234 · Cited by 110 · see citing works
Neumann, T., Wójcik, M., Berkowitsch, A., Erkapic, D., Zaltsberg, S., Greiß, H., Pajitnev, D., Lehinant, S., Schmitt, J., Hamm, C. W., et al. (2013) · EP Europace · doi:10.1093/europace/eut021 · Cited by 86 · see citing works
Self-citationGu, J. F., Liu, X., Wang, X., Shi, H., Tan, H., Zhou, L., Gu, J., Jiang, W., & Wang, Y. (2011) · EP Europace · doi:10.1093/europace/eur131 · Cited by 80 · see citing works
Long-term follow-up after radiofrequency catheter ablation for atrial fibrillation
Katritsis, D. G., Wood, M. A., Giazitzoglou, E., Shepard, R. K., Kourlaba, G., & Ellenbogen, K. A. (2008) · EP Europace · doi:10.1093/europace/eun018 · Cited by 64 · see citing works
Self-citationEvidence for a role of advanced glycation end products in atrial fibrillation
Raposeiras‐Roubín, S., Rodiño‐Janeiro, B. K., Grigorian-Shamagian, L., Seoane‐Blanco, A., Moure‐González, M., Roman, A. V., Álvarez, E., & González‐Juanatey, J. R. (2011) · International Journal of Cardiology · doi:10.1016/j.ijcard.2011.05.072 · Cited by 59 · see citing works
Anselmino, M., Öhrvik, J., Rydén, L., & on behalf of the Euro Heart Survey Investigators (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq368 · Cited by 52 · see citing works
Self-citationCardiomyopathy in Type 2 Diabetes
Saunders, J. A., Mathewkutty, S., Drazner, M. H., & McGuire, D. K. (2008) · Herz · doi:10.1007/s00059-008-3115-3 · Cited by 51 · see citing works
Fiala, M., Wichterle, D., Bulková, V., Sknouril, L., Nevřalová, R., Toman, O., Dorda, M., Januška, J., & Špinar, J. (2013) · EP Europace · doi:10.1093/europace/eut161 · Cited by 47 · see citing works
Self-citationAndersson, C., Gislason, G., Weeke, P. E., Hoffmann, S., Hansen, P. R., Torp-Pedersen, C. T., & Søgaard, P. (2010) · Cardiovascular Diabetology · doi:10.1186/1475-2840-9-3 · Cited by 39 · see citing works
Tang, R. B., Dong, J., Liu, X. P., Fang, D. P., Long, D., Liu, X., Yu, R. H., Hu, F. L., Lu, C. S., Hao, P., et al. (2007) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-006-9049-x · Cited by 37 · see citing works
Soran, H., Younis, N., Currie, P., Silas, J. H., Jones, I. R., & Gill, G. (2008) · QJM · doi:10.1093/qjmed/hcm123 · Cited by 24 · see citing works
Cardiovascular Prevention in Patients with Diabetes and Prediabetes
Anselmino, M., Gohlke, H., Mellbin, L., & Rydén, L. (2008) · Herz · doi:10.1007/s00059-008-3105-5 · Cited by 16 · see citing works
Self-citationHistory of transcatheter atrial fibrillation ablation
Anselmino, M., D’Ascenzo, F., Amoroso, G. R., Ferraris, F., & Gaïta, F. (2011) · Journal of Cardiovascular Medicine · doi:10.2459/jcm.0b013e32834ead59 · Cited by 16 · see citing works
Self-citationDiabetes Mellitus Reduces the Antiarrhythmic Effect of Ion Channel Blockers
Ito, I., Hayashi, Y., Kawai, Y., et al. (2006) · Anesthesia & Analgesia · doi:10.1213/01.ane.0000229709.29185.88 · Cited by 15 · see citing works
Anselmino, M., Malmberg, K., Mellbin, L., & Rydén, L. (2010) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-010-9136-2 · Cited by 10 · see citing works
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Research works printed but not linked: 1
- Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D et al. Meta-analysis of observational studies in epidemiology: proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 2000;283:2008 -12.
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2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes.
Marx, N., Federici, M., Schütt, K., Müller-Wieland, D., Ajjan, R. A., Antunes, M. J., Christodorescu, R. M., Crawford, C., Di Angelantonio, E., Eliasson, B., et al. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad192 · Cited by 1,642 · see citing works
Gorenek, B., Boriani, G., Dan, G.-A., Fauchier, L., Fenelon, G., Huang, H., Kudaiberdieva, G., Lip, G. Y. H., Mahajan, R., Potpara, T., et al. (2018) · EP Europace · doi:10.1093/europace/euy051 · Cited by 43 · see citing works
Bogossian, H., Frommeyer, G., Brachmann, J., Lewalter, T., Hoffmann, E., Kuck, K. H., Andresen, D., Willems, S., Spitzer, S. G., Deneke, T., et al. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.03.069 · Cited by 32 · see citing works
- Authors
- Anselmino, M., Matta, M., D'ascenzo, F., Pappone, C., Santinelli, V., Bunch, T. J., Neumann, T., Schilling, R. J., Hunter, R. J., Noelker, G., Fiala, M., Frontera, A., Thomas, G., Katritsis, D., Jais, P., Weerasooriya, R., Kalman, J. M., & Gaita, F.
- Affiliations
- Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT)
- Maria Cecilia Hospital (IT)
- Intermountain Healthcare (US)
- Kerckhoff Klinik (DE)
- National Health Service (GB)
- Heart and Diabetes Center North Rhine-Westphalia (DE)
- Nemocnice Podlesí (CZ)
- University Hospitals Bristol NHS Foundation Trust (GB)
- Athens Euroclinic (GR)
- The University of Western Australia (AU)
- The Royal Melbourne Hospital (AU)
- ORCID
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-10
- Volume
- 17
- Issue
- 10
- Pages
- 1518-1525
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W1890486457
- Cited by
- 88
- References
- 42
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 16 · 2023: 8 · 2022: 9 · 2021: 8 · 2020: 9 · 2019: 7 · 2018: 5 · 2017: 5 · 2016: 4
- FWCI
- 0.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- atrial fibrillation, catheter ablation, diabetes mellitus, arrhythmia recurrence, antiarrhythmic drugs, procedural complications, HbA1c, body mass index, old age, long-term outcomes, sinus rhythm maintenance
- MeSH terms
- Anti-Arrhythmia Agents, Atrial Fibrillation, Humans, Recurrence, Treatment Outcome, Catheter Ablation, Diabetes Complications
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