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Background <p>Type 2 diabetes mellitus (T2DM) is a modifiable risk factor both for atrial fibrillation (AF) and for the development of cerebrovascular-events in patients with AF. The aim of our study was to determine the effect of cryoballoon ablation (CBA) treatment on long-term atrial-tachyarrhythmia recurrence and adverse cardiovascular (CV) events in paroxysmal AF patients with T2DM.</p> Methods <p>This retrospective-observational-cohort study included 748-patients (406-male,342-female,59.4 ± 11.8years) who underwent CBA with a diagnosis of paroxysmal AF between 2013−2023. The primary endpoint was atrial tachyarrhythmia recurrence (After-CBA≥3months) and the secondary endpoint was development of CV-events (CV mortality, non-fatal myocardial infarction and cerebrovascular-events). All patients were followed up for at least 24 months for atrial-tachyarrhythmia recurrence and CV event development.</p> Results <p>The prevalence of T2DM was 26% in patients who underwent CBA. Atrial-tachyarrhythmia recurrence and CV events were more frequent in the T2DM group (24%vs15%,<i>p</i> = 0.004 and 33%vs9%,<i>p</i> = 0.045, respectively). Systolic-diastolic blood pressure, female gender, frequency of T2DM and anti-diabetic drug use, and left atrial diameter (LAd) values were higher in patients with atrial-tachyarrhythmia recurrence (<i>p</i> &lt; 0.05). The presence of LAd and T2DM were shown to independently predict the development of atrial-tachyarrhythmia recurrence (OR = 1.235,95%CI-1.169-1.305, <i>p</i> &lt; 0.001andOR = 1.843,95%CI-1.116-3.406,<i>p</i> = 0.030). Male-gender and presence of T2DM, CHA<sub>2</sub>DS<sub>2</sub>-VA score and uric-acid were shown to independently predict CV events (OR = 1.906,95%CI1.102-3.299,<i>p</i> = 0.021,OR = 2.148,95%CI-1.073-4.303,<i>p</i> = 0.013,OR = 1.613,95%CI-1.346-1.932,<i>p</i> = 0.001andOR = 1.322,95%CI-1.125-1.554,<i>p</i> = 0.001).</p> Conclusion <p>The presence of T2DM is an important, independent and modifiable risk factor for both atrial-tachyarrhythmia recurrence and adverse CV events in patients treated with CBA for AF. It was concluded that comprehensive management of T2DM is necessary to improve long-term outcomes of CBA.</p> Graphical Abstract <p></p>

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Atrial fibrillation ablation in patients with type 2 diabetes mellitus: long-term follow-up study for atrial tachyarrhythmia recurrence and adverse cardiovascular events

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  • 发表日期：

    2026年4月11日

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  • Mustafa Lütfullah Ardıç,
  • Abdullah Eren Cetin,
  • Hasan Burak Ozdemir,
  • Fadime Koca,
  • Hilmi Erdem Sumbul,
  • Mevlut Koc

摘要

Background

Type 2 diabetes mellitus (T2DM) is a modifiable risk factor both for atrial fibrillation (AF) and for the development of cerebrovascular-events in patients with AF. The aim of our study was to determine the effect of cryoballoon ablation (CBA) treatment on long-term atrial-tachyarrhythmia recurrence and adverse cardiovascular (CV) events in paroxysmal AF patients with T2DM.

Methods

This retrospective-observational-cohort study included 748-patients (406-male,342-female,59.4 ± 11.8years) who underwent CBA with a diagnosis of paroxysmal AF between 2013−2023. The primary endpoint was atrial tachyarrhythmia recurrence (After-CBA≥3months) and the secondary endpoint was development of CV-events (CV mortality, non-fatal myocardial infarction and cerebrovascular-events). All patients were followed up for at least 24 months for atrial-tachyarrhythmia recurrence and CV event development.

Results

The prevalence of T2DM was 26% in patients who underwent CBA. Atrial-tachyarrhythmia recurrence and CV events were more frequent in the T2DM group (24%vs15%,p = 0.004 and 33%vs9%,p = 0.045, respectively). Systolic-diastolic blood pressure, female gender, frequency of T2DM and anti-diabetic drug use, and left atrial diameter (LAd) values were higher in patients with atrial-tachyarrhythmia recurrence (p < 0.05). The presence of LAd and T2DM were shown to independently predict the development of atrial-tachyarrhythmia recurrence (OR = 1.235,95%CI-1.169-1.305, p < 0.001andOR = 1.843,95%CI-1.116-3.406,p = 0.030). Male-gender and presence of T2DM, CHA2DS2-VA score and uric-acid were shown to independently predict CV events (OR = 1.906,95%CI1.102-3.299,p = 0.021,OR = 2.148,95%CI-1.073-4.303,p = 0.013,OR = 1.613,95%CI-1.346-1.932,p = 0.001andOR = 1.322,95%CI-1.125-1.554,p = 0.001).

Conclusion

The presence of T2DM is an important, independent and modifiable risk factor for both atrial-tachyarrhythmia recurrence and adverse CV events in patients treated with CBA for AF. It was concluded that comprehensive management of T2DM is necessary to improve long-term outcomes of CBA.

Graphical Abstract