Catheter Ablation of Atrial Fibrillation in Patients with Diabetes Mellitus Type 2: Results from a Randomized Study Comparing Pulmonary Vein Isolation Versus Antiarrhythmic Drug Therapy
Catheter Ablation of Atrial Fibrillation in Patients with Diabetes Mellitus Type 2: Results from a Randomized Study Comparing Pulmonary Vein Isolation Versus Antiarrhythmic Drug Therapy
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DOI：
10.1111/j.1540-8167.2008.01275.x
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发表时间：
2009-01-01
影响因子：
2.7
通讯作者：
Tondo, Claudio
中科院分区：
文献类型：
--
作者：
Forleo, Giovanni B.;Mantica, Massimo;Tondo, Claudio
心房颤动（AF）和2型糖尿病（DM2）经常共存；然而，在先前的研究中，有少数DM2患者接受房颤导管消融（CA）。方法与结果：从2005年1月至2006年9月，70例诊断为DM2并阵发性或持续性房颤的患者（n = 29）随机接受肺静脉隔离或一种新的抗心律失常药物治疗（ADT），随访1年。主要终点为首次房颤复发的时间。通过Kaplan-Meier分析，随访结束时，42.9%的ADT组患者和80%的接受单次消融且无药物治疗的患者无房颤（P = 0.001）。在消融组中，与ADT组相比，生活质量（QoL）评分有显著改善。ADT组有6例（17.1%）出现明显的药物不良反应。ADT组随访期间住院率较高（P = 0.01）。唯一可归因于消融的并发症是一个明显的通路部位血肿。结论：在DM2患者中，房颤CA比ADT具有显著的临床益处，并且在可行性，有效性和低手术风险方面似乎是一种合理的方法。（Vol. 20, pp. 22-28, 2009年1月）。
Introduction: Atrial fibrillation (AF) and diabetes mellitus type 2 (DM2) often coexist; however, a small number of patients with DM2 undergoing catheter ablation (CA) of AF have been included in previous studies. The aim of this study was to evaluate safety and efficacy of ablation therapy in DM2 patients with drug refractory AF.Methods and Results: From January 2005 to September 2006, 70 patients with a diagnosis of DM2 and paroxysmal (n = 29) or persistent (n = 41) AF were randomized to receive either pulmonary vein isolation or a new antiarrhythmic drug treatment (ADT) with a 1-year follow-up. The primary endpoint was the time to first AF recurrence. By Kaplan-Meier analysis, at the end of follow-up, 42.9% of patients in the ADT group and 80% of patients who received a single ablation procedure and were without medications were free of AF (P = 0.001). In the ablation group, a significant improvement in quality-of-life (QoL) scores as compared with ADT group was observed. Six patients in the ADT group (17.1%) developed significant adverse drug effects. Hospitalization rate during follow-up was higher in the ADT group (P = 0.01). The only complication attributable to ablation was one significant access-site hematoma.Conclusion: In patients with DM2, CA of AF provides significant clinical benefits over the ADT and appears to be a reasonable approach regarding feasibility, effectiveness, and low procedural risk.(J Cardiovasc Electrophysiol, Vol. 20, pp. 22-28, January 2009).