Atrial fibrillation ablation in patients with type 2 diabetes mellitus: long-term follow-up study for atrial tachyarrhythmia recurrence and adverse cardiovascular events
Irish Journal of Medical Science, cilt.195, sa.4, ss.1911-1922, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 195 Sayı: 4
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11845-026-04380-5
- Dergi Adı: Irish Journal of Medical Science
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.1911-1922
- Anahtar Kelimeler: Atrial fibrillation, Type 2 diabetes mellitus, Cryoballoon ablation, Cardiovascular event
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
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.