Objectives: The aim of this study was to investigate the impact of improved glycemic control on atrial fibrillation (AF) recurrence rates after ablation.
Background: Diabetes is associated with increased rates of AF. The impact of improved pre-ablation glycemic control remains unknown.
Methods: The 12-month pre-ablation trends in glycemic control were studied in 298 patients with diabetes undergoing AF ablation. Recurrence data were obtained during a mean follow-up period of 25.92 ± 20.26 months post-ablation.
Results: Higher glycated hemoglobin (HbA1c) at the time of ablation was associated with higher post-ablation recurrence rates. More than two-thirds (68.75%) of patients with HbA1c >9% at the time of ablation developed recurrent AF, compared with 32.4% of those with HbA1c <7% (p < 0.0001). On multivariate analysis, only the 12-month trend in HbA1c was significantly associated with AF recurrence. Although 91.1% of patients with a worsening trend in HbA1c during the 12 months prior to ablation developed recurrent AF, only 2% of patients with improvements in HbA1c of 10% or more experienced AF recurrence (p < 0.0001).
Conclusions: The trend in glycemic control prior to ablation predicts arrhythmia recurrence after ablation. A multidisciplinary approach to reduce HbA1c is imperative in patients with diabetes with AF to reduce recurrence rates after ablation.
Keywords: ablation; atrial fibrillation; diabetes.
Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.