Diabetes influences the cardiac symptoms related to atrial fibrillation
Open accessAbstract
It is well known that diabetes mellitus (DM) masks the cardiac symptoms during an ischemic heart attack, but there have not been reports of whether DM influences the subjective symptoms of atrial fibrillation (AF). The present study retrospectively assessed 65 patients who were revealed to be in sinus rhythm at their first visit to hospital and who had experienced episodes of AF (or paroxysmal AF) during the follow-up period. Compared with non-DM cases (n=50), DM patients (n=15) had a tendency to a more rapid heart rate in sinus rhythm (73+/-4 vs 66+/-2, p=0.07) and higher averaged ventricular response at the first-recorded episode of AF (111+/-7 vs 99+/-3, p=0.10). However, the ratio of symptomatic cases at first-recorded AF tended to be lower in DM cases (33% vs 58%, p=0.08). When patients with beta-blockers or other antiarrhythmic agents were excluded, the ratio of symptomatic patients at first-recorded AF was significantly lower in the DM cases (25% vs 61%, p=0.04), although there was not a significant difference in averaged ventricular response at first-recorded AF (112+/-8 vs 106+/-5). The prevalence of DM neuropathy was significantly higher in asymptomatic patients (70% vs 0%, p=0.01). DM may mask the cardiac symptoms of the first-recorded episode of AF, possibly because of DM neuropathy.
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Although cardiac rhythm disorders generally give rise to palpitations, in some subjects arrhythmias including prognostically relevant disorders such as non-sustained ventricular tachycardias and atrial fibrillation may remain completely asymptomatic.
“It is important to underline the fact that, although cardiac rhythm disorders generally give rise to palpitations (or other related symptoms, such as fatigue, dyspnoea, dizziness, syncope, and angina), in some subjects, for reasons not entirely known but probably linked to some clinical characteristics (long-standing arrhythmias with relatively low maximum ventricular rate, male sex, absence of”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [11]
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- Authors
- Sugishita, K., Shiono, E., Sugiyama, T., & Ashida, T.
- Affiliations
- The Institute of Medical Science, Asahi Life Foundation (JP)
- Venue
- Circulation Journal
- Publisher
- Japanese Circulation Society
- Published
- 2003
- Volume
- 67
- Issue
- 10
- Pages
- 835-838
- ISSN
- 1346-9843 (ISSN-L)
- 1347-4820
- OpenAlex
- W2167580546
- Cited by
- 37
- References
- 7
- Citations by year
- 2025: 1 · 2024: 5 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 2 · 2014: 4 · 2013: 2 · 2012: 1
- FWCI
- 0.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- diabetes mellitus, atrial fibrillation, paroxysmal atrial fibrillation, cardiac symptoms, symptom masking, diabetic neuropathy, ventricular response, heart rate, antiarrhythmic drugs, beta-blockers
- MeSH terms
- Aged, Anti-Arrhythmia Agents, Atrial Fibrillation, Diabetic Neuropathies, Electrocardiography, Female, Heart Rate, Humans, Male, Middle Aged, Retrospective Studies, Sex Factors, Case-Control Studies, Diabetes Complications
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