Diabetes mellitus and atrial fibrillation: Pathophysiological mechanisms and potential upstream therapies

Int J Cardiol. 2015 Apr 1;184:617-622. doi: 10.1016/j.ijcard.2015.03.052. Epub 2015 Mar 5.


Diabetes mellitus (DM) represents one of the most important risk factors for atrial fibrillation (AF) while AF is a strong and independent marker of overall mortality and cardiovascular morbidity in diabetic patients. Autonomic, electrical, electromechanical, and structural remodeling, including oxidative stress, connexin remodeling and glycemic fluctuations seem to be implicated in AF pathophysiology in the setting of DM. The present review highlights the association between DM and AF, provides a comprehensive overview of the responsible pathophysiological mechanisms and briefly discusses potential upstream therapies for DM-related atrial remodeling.

Keywords: Atrial fibrillation; Atrial remodeling; Diabetes mellitus; Upstream therapies.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / therapeutic use
  • Antioxidants / therapeutic use
  • Atrial Fibrillation / metabolism
  • Atrial Fibrillation / physiopathology*
  • Atrial Fibrillation / therapy*
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / physiopathology*
  • Diabetes Mellitus / therapy*
  • Humans
  • Oxidative Stress / physiology
  • Risk Factors
  • Ventricular Remodeling / physiology


  • Anti-Inflammatory Agents
  • Antioxidants