Impact of diabetes mellitus and poor glycemic control on the prevalence of left atrial low‐voltage areas and rhythm outcome in patients with atrial fibrillation ablation

Introduction Left atrial low‐voltage areas (LVAs) are known to be correlated with atrial scarring and atrial fibrillation (AF) recurrence after ablation. However, the association between LVAs and glycemic status before ablation has not been fully clarified. The purpose of this study was to investiga...

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Published in:Journal of cardiovascular electrophysiology 2024-04, Vol.35 (4), p.775-784
Main Authors: Matsuda, Yasuhiro, Masuda, Masaharu, Uematsu, Hiroyuki, Sugino, Ayako, Ooka, Hirotaka, Kudo, Satoshi, Fujii, Subaru, Asai, Mitsutoshi, Okamoto, Shin, Ishihara, Takayuki, Nanto, Kiyonori, Tsujimura, Takuya, Hata, Yosuke, Higashino, Naoko, Nakao, Sho, Kusuda, Masaya, Mano, Toshiaki
Format: Article
Language:English
Subjects:
Ablation
atrial fibrillation
Cardiac arrhythmia
catheter ablation
Diabetes
Diabetes mellitus
Fibrillation
Hemoglobin
low‐voltage areas
Multivariate analysis
Voltage
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container_title Journal of cardiovascular electrophysiology
container_volume 35
creator Matsuda, Yasuhiro
Masuda, Masaharu
Uematsu, Hiroyuki
Sugino, Ayako
Ooka, Hirotaka
Kudo, Satoshi
Fujii, Subaru
Asai, Mitsutoshi
Okamoto, Shin
Ishihara, Takayuki
Nanto, Kiyonori
Tsujimura, Takuya
Hata, Yosuke
Higashino, Naoko
Nakao, Sho
Kusuda, Masaya
Mano, Toshiaki
description Introduction Left atrial low‐voltage areas (LVAs) are known to be correlated with atrial scarring and atrial fibrillation (AF) recurrence after ablation. However, the association between LVAs and glycemic status before ablation has not been fully clarified. The purpose of this study was to investigate associations among the prevalence of diabetes mellitus (DM), glycemic control, and the prevalence of LVAs in patients with AF ablation. Methods In total, 912 (age, 68 ± 10 years; female, 299 [33%]; persistent AF, 513 [56%]) consecutive patients who underwent initial AF ablation were included. A preprocedure glycated hemoglobin A1c (HbA1c) ≥7% was set as the cutoff for poor glycemic control in patients with DM. LVAs were defined as areas with a bipolar voltage of
doi_str_mv 10.1111/jce.16219
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However, the association between LVAs and glycemic status before ablation has not been fully clarified. The purpose of this study was to investigate associations among the prevalence of diabetes mellitus (DM), glycemic control, and the prevalence of LVAs in patients with AF ablation. Methods In total, 912 (age, 68 ± 10 years; female, 299 [33%]; persistent AF, 513 [56%]) consecutive patients who underwent initial AF ablation were included. A preprocedure glycated hemoglobin A1c (HbA1c) ≥7% was set as the cutoff for poor glycemic control in patients with DM. LVAs were defined as areas with a bipolar voltage of &lt;0.5 mV covering ≥5 cm2 of left atrium. Results LVAs existed in 208 (23%) patients, and 168 (18%) patients had DM. LVAs were found more frequently in patients with DM and poor glycemic control. On multivariate analysis, DM with HbA1c ≥7% was an independent predictor of LVAs (odds ratio, 3.3; 95% confidence interval: 1.6–6.7; p = .001). In patients with LVAs, freedom from AF recurrence during the 24‐month study period was significantly lower in patients who had DM with HbA1c ≥7% than in those without DM (37.9% vs. 54.7%, p = .02). Conclusion In patients with AF ablation, LVAs were found more frequently in patients with DM and poor glycemic control. DM with HbA1c ≥7% was an independent predictor of LVAs. In patients with atrial fibrillation (AF) ablation and diabetes mellitus (DM), the prevalence of left atrial low‐voltage areas (LVAs) increased with increasing glycated hemoglobin A1c (HbA1c) level. In patients with LVAs, freedom from AF recurrence was lower in patients who had DM with HbA1c ≥7% than in those without DM.</description><identifier>ISSN: 1045-3873</identifier><identifier>EISSN: 1540-8167</identifier><identifier>DOI: 10.1111/jce.16219</identifier><identifier>PMID: 38375957</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Ablation ; atrial fibrillation ; Cardiac arrhythmia ; catheter ablation ; Diabetes ; Diabetes mellitus ; Fibrillation ; Hemoglobin ; low‐voltage areas ; Multivariate analysis ; Voltage</subject><ispartof>Journal of cardiovascular electrophysiology, 2024-04, Vol.35 (4), p.775-784</ispartof><rights>2024 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-632842f9b44fd197e2be3999539c60a7344127b102724f4763a3de63503ef5643</citedby><cites>FETCH-LOGICAL-c3539-632842f9b44fd197e2be3999539c60a7344127b102724f4763a3de63503ef5643</cites><orcidid>0000-0002-5566-466X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38375957$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Matsuda, Yasuhiro</creatorcontrib><creatorcontrib>Masuda, Masaharu</creatorcontrib><creatorcontrib>Uematsu, Hiroyuki</creatorcontrib><creatorcontrib>Sugino, Ayako</creatorcontrib><creatorcontrib>Ooka, Hirotaka</creatorcontrib><creatorcontrib>Kudo, Satoshi</creatorcontrib><creatorcontrib>Fujii, Subaru</creatorcontrib><creatorcontrib>Asai, Mitsutoshi</creatorcontrib><creatorcontrib>Okamoto, Shin</creatorcontrib><creatorcontrib>Ishihara, Takayuki</creatorcontrib><creatorcontrib>Nanto, Kiyonori</creatorcontrib><creatorcontrib>Tsujimura, Takuya</creatorcontrib><creatorcontrib>Hata, Yosuke</creatorcontrib><creatorcontrib>Higashino, Naoko</creatorcontrib><creatorcontrib>Nakao, Sho</creatorcontrib><creatorcontrib>Kusuda, Masaya</creatorcontrib><creatorcontrib>Mano, Toshiaki</creatorcontrib><title>Impact of diabetes mellitus and poor glycemic control on the prevalence of left atrial low‐voltage areas and rhythm outcome in patients with atrial fibrillation ablation</title><title>Journal of cardiovascular electrophysiology</title><addtitle>J Cardiovasc Electrophysiol</addtitle><description>Introduction Left atrial low‐voltage areas (LVAs) are known to be correlated with atrial scarring and atrial fibrillation (AF) recurrence after ablation. However, the association between LVAs and glycemic status before ablation has not been fully clarified. The purpose of this study was to investigate associations among the prevalence of diabetes mellitus (DM), glycemic control, and the prevalence of LVAs in patients with AF ablation. Methods In total, 912 (age, 68 ± 10 years; female, 299 [33%]; persistent AF, 513 [56%]) consecutive patients who underwent initial AF ablation were included. A preprocedure glycated hemoglobin A1c (HbA1c) ≥7% was set as the cutoff for poor glycemic control in patients with DM. LVAs were defined as areas with a bipolar voltage of &lt;0.5 mV covering ≥5 cm2 of left atrium. Results LVAs existed in 208 (23%) patients, and 168 (18%) patients had DM. LVAs were found more frequently in patients with DM and poor glycemic control. On multivariate analysis, DM with HbA1c ≥7% was an independent predictor of LVAs (odds ratio, 3.3; 95% confidence interval: 1.6–6.7; p = .001). In patients with LVAs, freedom from AF recurrence during the 24‐month study period was significantly lower in patients who had DM with HbA1c ≥7% than in those without DM (37.9% vs. 54.7%, p = .02). Conclusion In patients with AF ablation, LVAs were found more frequently in patients with DM and poor glycemic control. DM with HbA1c ≥7% was an independent predictor of LVAs. In patients with atrial fibrillation (AF) ablation and diabetes mellitus (DM), the prevalence of left atrial low‐voltage areas (LVAs) increased with increasing glycated hemoglobin A1c (HbA1c) level. In patients with LVAs, freedom from AF recurrence was lower in patients who had DM with HbA1c ≥7% than in those without DM.</description><subject>Ablation</subject><subject>atrial fibrillation</subject><subject>Cardiac arrhythmia</subject><subject>catheter ablation</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Fibrillation</subject><subject>Hemoglobin</subject><subject>low‐voltage areas</subject><subject>Multivariate analysis</subject><subject>Voltage</subject><issn>1045-3873</issn><issn>1540-8167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kU9u1TAQhyMEoqWw4ALIEhtYpPW_2PESPZVSVIkNrC3HmfT5yYmD7fTp7ThC79FbcZK6pGWBhDcz0nz-bM2vqt4SfErKOdtZOCWCEvWsOiYNx3VLhHxeesybmrWSHVWvUtphTJjAzcvqiLVMNqqRx9Xd5Tgbm1EYUO9MBxkSGsF7l5eEzNSjOYSIrv3BwugssmHKMXgUJpS3gOYIN8bDZOFB4GHIyOTojEc-7H__ur0JPptrQCaCWXVxe8jbEYUl2zACchOaTXYw5YT2Lm-frg-ui877MiovmW5tXlcvBuMTvHmsJ9WPz-ffN1_qq28Xl5tPV7VlDVO1YLTldFAd50NPlATaAVNKlZkV2EjGOaGyI5hKygcuBTOsB8EazGBoBGcn1YfVO8fwc4GU9eiSLUsxE4Qlaapo2zZUKVbQ9_-gu7DEqfxOM8y4kEJyXKiPK2VjSCnCoOfoRhMPmmD9kKAuCeo_CRb23aNx6Ubo_5JPkRXgbAX2zsPh_yb9dXO-Ku8BJsinpA</recordid><startdate>202404</startdate><enddate>202404</enddate><creator>Matsuda, Yasuhiro</creator><creator>Masuda, Masaharu</creator><creator>Uematsu, Hiroyuki</creator><creator>Sugino, Ayako</creator><creator>Ooka, Hirotaka</creator><creator>Kudo, Satoshi</creator><creator>Fujii, Subaru</creator><creator>Asai, Mitsutoshi</creator><creator>Okamoto, Shin</creator><creator>Ishihara, Takayuki</creator><creator>Nanto, Kiyonori</creator><creator>Tsujimura, Takuya</creator><creator>Hata, Yosuke</creator><creator>Higashino, Naoko</creator><creator>Nakao, Sho</creator><creator>Kusuda, Masaya</creator><creator>Mano, Toshiaki</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5566-466X</orcidid></search><sort><creationdate>202404</creationdate><title>Impact of diabetes mellitus and poor glycemic control on the prevalence of left atrial low‐voltage areas and rhythm outcome in patients with atrial fibrillation ablation</title><author>Matsuda, Yasuhiro ; Masuda, Masaharu ; Uematsu, Hiroyuki ; Sugino, Ayako ; Ooka, Hirotaka ; Kudo, Satoshi ; Fujii, Subaru ; Asai, Mitsutoshi ; Okamoto, Shin ; Ishihara, Takayuki ; Nanto, Kiyonori ; Tsujimura, Takuya ; Hata, Yosuke ; Higashino, Naoko ; Nakao, Sho ; Kusuda, Masaya ; Mano, Toshiaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-632842f9b44fd197e2be3999539c60a7344127b102724f4763a3de63503ef5643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Ablation</topic><topic>atrial fibrillation</topic><topic>Cardiac arrhythmia</topic><topic>catheter ablation</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Fibrillation</topic><topic>Hemoglobin</topic><topic>low‐voltage areas</topic><topic>Multivariate analysis</topic><topic>Voltage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matsuda, Yasuhiro</creatorcontrib><creatorcontrib>Masuda, Masaharu</creatorcontrib><creatorcontrib>Uematsu, Hiroyuki</creatorcontrib><creatorcontrib>Sugino, Ayako</creatorcontrib><creatorcontrib>Ooka, Hirotaka</creatorcontrib><creatorcontrib>Kudo, Satoshi</creatorcontrib><creatorcontrib>Fujii, Subaru</creatorcontrib><creatorcontrib>Asai, Mitsutoshi</creatorcontrib><creatorcontrib>Okamoto, Shin</creatorcontrib><creatorcontrib>Ishihara, Takayuki</creatorcontrib><creatorcontrib>Nanto, Kiyonori</creatorcontrib><creatorcontrib>Tsujimura, Takuya</creatorcontrib><creatorcontrib>Hata, Yosuke</creatorcontrib><creatorcontrib>Higashino, Naoko</creatorcontrib><creatorcontrib>Nakao, Sho</creatorcontrib><creatorcontrib>Kusuda, Masaya</creatorcontrib><creatorcontrib>Mano, Toshiaki</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matsuda, Yasuhiro</au><au>Masuda, Masaharu</au><au>Uematsu, Hiroyuki</au><au>Sugino, Ayako</au><au>Ooka, Hirotaka</au><au>Kudo, Satoshi</au><au>Fujii, Subaru</au><au>Asai, Mitsutoshi</au><au>Okamoto, Shin</au><au>Ishihara, Takayuki</au><au>Nanto, Kiyonori</au><au>Tsujimura, Takuya</au><au>Hata, Yosuke</au><au>Higashino, Naoko</au><au>Nakao, Sho</au><au>Kusuda, Masaya</au><au>Mano, Toshiaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of diabetes mellitus and poor glycemic control on the prevalence of left atrial low‐voltage areas and rhythm outcome in patients with atrial fibrillation ablation</atitle><jtitle>Journal of cardiovascular electrophysiology</jtitle><addtitle>J Cardiovasc Electrophysiol</addtitle><date>2024-04</date><risdate>2024</risdate><volume>35</volume><issue>4</issue><spage>775</spage><epage>784</epage><pages>775-784</pages><issn>1045-3873</issn><eissn>1540-8167</eissn><abstract>Introduction Left atrial low‐voltage areas (LVAs) are known to be correlated with atrial scarring and atrial fibrillation (AF) recurrence after ablation. However, the association between LVAs and glycemic status before ablation has not been fully clarified. The purpose of this study was to investigate associations among the prevalence of diabetes mellitus (DM), glycemic control, and the prevalence of LVAs in patients with AF ablation. Methods In total, 912 (age, 68 ± 10 years; female, 299 [33%]; persistent AF, 513 [56%]) consecutive patients who underwent initial AF ablation were included. A preprocedure glycated hemoglobin A1c (HbA1c) ≥7% was set as the cutoff for poor glycemic control in patients with DM. LVAs were defined as areas with a bipolar voltage of &lt;0.5 mV covering ≥5 cm2 of left atrium. Results LVAs existed in 208 (23%) patients, and 168 (18%) patients had DM. LVAs were found more frequently in patients with DM and poor glycemic control. On multivariate analysis, DM with HbA1c ≥7% was an independent predictor of LVAs (odds ratio, 3.3; 95% confidence interval: 1.6–6.7; p = .001). In patients with LVAs, freedom from AF recurrence during the 24‐month study period was significantly lower in patients who had DM with HbA1c ≥7% than in those without DM (37.9% vs. 54.7%, p = .02). Conclusion In patients with AF ablation, LVAs were found more frequently in patients with DM and poor glycemic control. DM with HbA1c ≥7% was an independent predictor of LVAs. In patients with atrial fibrillation (AF) ablation and diabetes mellitus (DM), the prevalence of left atrial low‐voltage areas (LVAs) increased with increasing glycated hemoglobin A1c (HbA1c) level. In patients with LVAs, freedom from AF recurrence was lower in patients who had DM with HbA1c ≥7% than in those without DM.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38375957</pmid><doi>10.1111/jce.16219</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-5566-466X</orcidid></addata></record>
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source Wiley-Blackwell Read & Publish Collection
subjects Ablation
atrial fibrillation
Cardiac arrhythmia
catheter ablation
Diabetes
Diabetes mellitus
Fibrillation
Hemoglobin
low‐voltage areas
Multivariate analysis
Voltage
title Impact of diabetes mellitus and poor glycemic control on the prevalence of left atrial low‐voltage areas and rhythm outcome in patients with atrial fibrillation ablation
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