Catheter ablation of atrial fibrillation in patients with diabetes mellitus type 2: results from a randomized study comparing pulmonary vein isolation versus antiarrhythmic drug therapy
Abstract
INTRODUCTION: Atrial fibrillation (AF) and diabetes mellitus type 2 (DM2) often coexist; however, a small number of patients with DM2 undergoing catheter ablation (CA) of AF have been included in previous studies. The aim of this study was to evaluate safety and efficacy of ablation therapy in DM2 patients with drug refractory AF. METHODS AND RESULTS: From January 2005 to September 2006, 70 patients with a diagnosis of DM2 and paroxysmal (n = 29) or persistent (n = 41) AF were randomized to receive either pulmonary vein isolation or a new antiarrhythmic drug treatment (ADT) with a 1-year follow-up. The primary endpoint was the time to first AF recurrence. By Kaplan-Meier analysis, at the end of follow-up, 42.9% of patients in the ADT group and 80% of patients who received a single ablation procedure and were without medications were free of AF (P = 0.001). In the ablation group, a significant improvement in quality-of-life (QoL) scores as compared with ADT group was observed. Six patients in the ADT group (17.1%) developed significant adverse drug effects. Hospitalization rate during follow-up was higher in the ADT group (P = 0.01). The only complication attributable to ablation was one significant access-site hematoma. CONCLUSION: In patients with DM2, CA of AF provides significant clinical benefits over the ADT and appears to be a reasonable approach regarding feasibility, effectiveness, and low procedural risk.
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Most patients require more than one procedure to achieve symptom control after catheter ablation of atrial fibrillation.
“Most patients require more than one procedure to achieve symptom control.713,726,728”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [726]
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- Authors
- FORLEO, G. B., MANTICA, M., DE LUCA, L., LEO, R., SANTINI, L., PANIGADA, S., DE SANCTIS, V., PAPPALARDO, A., LAURENZI, F., AVELLA, A., CASELLA, M., RUSSO, A. D., ROMEO, F., PELARGONIO, G., & TONDO, C.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- Istituto Clinico Sant'Ambrogio (IT)
- University of Rome Tor Vergata (IT)
- Corresponding author
- TONDO, CLAUDIO
- ORCID
- Venue
- Journal of Cardiovascular Electrophysiology
- Publisher
- Wiley
- Published
- 2008-12-29
- Volume
- 20
- Issue
- 1
- Pages
- 22-28
- ISSN
- 1045-3873 (ISSN-L)
- 1540-8167
- OpenAlex
- W2105908026
- Cited by
- 165
- References
- 28
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 6 · 2023: 10 · 2022: 7 · 2021: 8 · 2020: 15 · 2019: 5 · 2018: 12 · 2017: 11 · 2016: 11 · 2015: 11 · 2014: 11 · 2013: 11 · 2012: 14
- FWCI
- 5.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiovascular Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Università Politecnica delle Marche (Università Politecnica delle Marche) (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, type 2 diabetes, catheter ablation, pulmonary vein isolation, antiarrhythmic drugs, drug-refractory atrial fibrillation, atrial fibrillation recurrence, quality of life, adverse drug reactions, hospitalization, access site hematoma
- MeSH terms
- Anti-Arrhythmia Agents, Atrial Fibrillation, Diabetes Mellitus, Type 2, Female, Heart Conduction System, Humans, Italy, Male, Middle Aged, Pulmonary Veins, Treatment Outcome, Catheter Ablation
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