Safety and efficacy of catheter ablation of atrial fibrillation in patients with diabetes mellitus—single center experience

Abstract

Little is known about the outcome of catheter ablation of atrial fibrillation (AF) in patients with diabetes mellitus (DM). We investigated the safety and efficacy of catheter ablation of AF in patients with DM. Thirty one patients with DM from a group of 263 consecutive patients undergoing a first-time catheter ablation of AF procedure were enrolled in a prospective study. The ablation protocol (guided by CARTO system) consisted in two continuous circular lesions around ipsilateral pulmonary veins. The following clinical characteristics differed between DM and no-DM patients: age (62.0 +/- 10.8 vs. 56.1 +/- 10.6 years, P = 0.004), longer AF history (9.6 +/- 9.3 vs. 6.7 +/- 6.3 years, P = 0.024), significantly larger left atrium size (41.1 +/- 7.8 vs. 38.3 +/- 5.8 mm, P = 0.021), hypertension (58.1 vs. 35.8%, P = 0.018) and structural heart disease (67.7 vs. 43.5%, P = 0.011). Despite a similar AF recurrence rate in DM and no-DM patients (32.3 vs. 22.4%, P = 0.240), the ablation procedure was complicated in 28 patients (11 hematomas, three cardiac tamponades and three strokes) and the incidence of complications was significantly higher in DM than in no-DM patients (29.0 vs. 8.2%, respectively, P = 0.002). Multivariate analysis showed that DM was an independent risk factor for complications occurrence (odd ratio 5.936, 95% confidence interval 2.059 to 17.112, P = 0.001). First catheter ablation of AF procedure in DM patients was equally efficacious than in no-DM patients. However, DM patients had a higher incidence of complications, mostly thrombotic or hemorrhagic.