Association Between Pre-Ablation Glycemic Control and Outcomes Among Patients With Diabetes Undergoing AtrialFibrillation Ablation.

Abstract

The aim of this study was to investigate the impact of improved glycemic control on atrial fibrillation (AF) recurrence rates after ablation. Diabetes is associated with increased rates of AF. The impact of improved pre-ablation glycemic control remains unknown. 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 ± 20.26months post-ablation. 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 inHbA1c was significantly associated with AF recurrence. Although 91.1% of patients with a worsening trend in HbA1c during the 12months prior to ablation developed recurrent AF, only 2% of patients with improvements in HbA1c of 10% or more experienced AF recurrence (p<0.0001). The trend in glycemic control prior to ablation predicts arrhythmia recurrence after ablation. Amultidisciplinary approach to reduce HbA1c is imperative in patients with diabetes with AF to reduce recurrence ratesafter ablation.