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

Giovanni B. Forleo, Massimo Mantica, Lucia De Luca, Roberto Leo, Luca Santini, Stefania Panigada, Valerio De Sanctis, Augusto Pappalardo, Francesco Laurenzi, Andrea Avella, Michela Casella, Antonio Dello Russo, Francesco Romeo, Gemma Pelargonio, Claudio Tondo

Research output: Contribution to journalArticlepeer-review

Abstract

PVI Versus Drug Therapy in Diabetics. 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.

Original languageEnglish
Pages (from-to)22-28
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume20
Issue number1
DOIs
Publication statusPublished - Jan 2009

Keywords

  • Antiarrhythmic drugs
  • Atrial fibrillation
  • Catheter ablation
  • Diabetes mellitus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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