Author + information
- Received February 28, 2019
- Revision received May 16, 2019
- Accepted May 17, 2019
- Published online July 31, 2019.
- Eoin Donnellan, MD,
- Philip Aagaard, MD, PhD,
- Mohamed Kanj, MD,
- Wael Jaber, MD,
- Mohamed Elshazly, MD,
- Michael Hoosien, MD,
- Bryan Baranowski, MD,
- Ayman Hussein, MD,
- Walid Saliba, MD and
- Oussama Wazni, MD∗ ()
- ↵∗Address for correspondence:
Dr. Oussama Wazni, Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, Ohio 44195.
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 Twelve-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.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received February 28, 2019.
- Revision received May 16, 2019.
- Accepted May 17, 2019.
- 2019 American College of Cardiology Foundation
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