Harilaos Bogossian1, Gerrit Frommeyer2, Johannes Brachmann3, Thorsten Lewalter4, Ellen Hoffmann5, Karl Heinz Kuck6, Dietrich Andresen7, Stephan Willems8, Stefan G Spitzer9, Thomas Deneke10, Dierk Thomas11, Matthias Hochadel12, Jochen Senges12, Lars Eckardt2, Bernd Lemke13. 1. Märkische Kliniken GmbH, Klinikum Lüdenscheid, Lüdenscheid, Germany; Department of Cardiology, University Witten/Herdecke, Witten, Germany. Electronic address: Harilaos.bogossian@klinikum-luedenscheid.de. 2. Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital, Muenster, Germany. 3. Department of Cardiology, Hospital Coburg, Germany. 4. Klinik für Kardiologie und Internistische Intensivmedizin, Peter Osypka Herzzentrum Kliniken Dr. Müller, München, Germany. 5. Klinik für Kardiologie und Internistische Intensivmedizin, Klinikum München-Bogenhausen, München, Germany. 6. Department of Cardiology, Asklepios Hospital St. Georg, Hamburg, Germany. 7. Evangelische Elisabeth-Klinik, Berlin, Germany. 8. University Heart Center, Department of Cardiology and Electrophysiology, Hamburg, Germany. 9. Brandenburgische Technische Universität (BTU) Cottbus-Senftenberg, Germany; Praxisklinik Herz und Gefäße - Akademische Lehrpraxisklinik der TU Dresden, Dresden, Germany. 10. Clinic for Interventional Electrophysiology and Ruhr-University Bochum Heart Center, Bad Neustadt, Bavarian, Germany. 11. Department of Cardiology, University Hospital Heidelberg, Heidelberg, Germany. 12. Stiftung Institut fuer Herzinfarktforschung, Ludwigshafen, Germany. 13. Märkische Kliniken GmbH, Klinikum Lüdenscheid, Lüdenscheid, Germany.
Abstract
BACKGROUND: Diabetes mellitus (DM) is an independent risk factor for cardiovascular disease and arrhythmias. Procedural data and complication rates in patients with DM undergoing catheter ablation for atrial arrhythmias are unknown. METHODS: The German Ablation Registry has been designed as a multi-center prospective registry. Between January 2007 and January 2010 data from ablation of right atrial flutter (AFlut) and atrial fibrillation (AF) were collected from 51 German centres. Patients with DM and without DM were compared. RESULTS: We included 8175 patients who underwent catheter ablation of AFlut or AF. Patients with DM (n=944) were older and presented significantly more severe comorbidities. Major periprocedural complications did not significantly differ between patients with and without DM for both ablation of AFlut and AF. Kaplan-Meier survival analysis for 366days of follow-up, showed a significant increase of MACCE for DM patients as compared to controls after AFlut [6.1% vs. 3.4%(p=0.002)], but not after AF ablation [1.2% vs. 0.9%(p=0.59)]. Ablation of AFlut led to a comparable reduction of palpitations and NYHA class in both patient groups. AF ablation reduced palpitations and NYHA class in patients without DM, while patients with DM reported no improvement of NYHA class despite a reduction of palpitations. CONCLUSION: As compared to non-DM, patients with DM show no increased periprocedural risk and no increased arrhythmia recurrence after ablation of AFlut or AF. As expected patients with DM exhibit more comorbidities and an increased ongoing mortality after atrial flutter ablation presumably caused by the higher age of this group as compared to controls.
BACKGROUND:Diabetes mellitus (DM) is an independent risk factor for cardiovascular disease and arrhythmias. Procedural data and complication rates in patients with DM undergoing catheter ablation for atrial arrhythmias are unknown. METHODS: The German Ablation Registry has been designed as a multi-center prospective registry. Between January 2007 and January 2010 data from ablation of right atrial flutter (AFlut) and atrial fibrillation (AF) were collected from 51 German centres. Patients with DM and without DM were compared. RESULTS: We included 8175 patients who underwent catheter ablation of AFlut or AF. Patients with DM (n=944) were older and presented significantly more severe comorbidities. Major periprocedural complications did not significantly differ between patients with and without DM for both ablation of AFlut and AF. Kaplan-Meier survival analysis for 366days of follow-up, showed a significant increase of MACCE for DMpatients as compared to controls after AFlut [6.1% vs. 3.4%(p=0.002)], but not after AF ablation [1.2% vs. 0.9%(p=0.59)]. Ablation of AFlut led to a comparable reduction of palpitations and NYHA class in both patient groups. AF ablation reduced palpitations and NYHA class in patients without DM, while patients with DM reported no improvement of NYHA class despite a reduction of palpitations. CONCLUSION: As compared to non-DM, patients with DM show no increased periprocedural risk and no increased arrhythmia recurrence after ablation of AFlut or AF. As expected patients with DM exhibit more comorbidities and an increased ongoing mortality after atrial flutter ablation presumably caused by the higher age of this group as compared to controls.