P1373
Assessment of atrial fibrillation cryoablation outcomes in patients with diabetes
EP Europace Journal
Abstract
Diabetes is related with both AF occurence and increased thromboembolic risk. There is scarce data about the outcomes of AF catheter ablation in patients with diabetes.
We aimed to evaluate outcomes of AF catheter ablation in patients with diabetes.
All patients underwent AF cryoablation between January 2013 and January 2018 were included .
A total of 493 patients were enrolled. Mean age was 59.6 ± 11.8 years and 253 (51.3 %) patients were female. Median follow up time was 28 (6-59) months. Recurrence occured in 61 (12.4%) patients. Diabetes was present in 78 (16%) cases. Mean HbA1c value of the diabetic patients was 6.79 ± 1.02 %. 50 (64.1 %) patients was under treatment with only oral antidiabetics while others were using insulin. Diabetic group was older (p < 0.001) and hypertension prevalance was significantly higher in diabetics(p < 0.001). Complication and recurrence rates were similar between the two groups (Table-1). Subgroup analysis revealed that there was not significant difference by AF recurrence between not only patients treated with OAD alone and treated with insulin but also patients with HbA1c value <7 and HbA1c value ≥7 (p = 0.064).
Recurrence and complication rates were similar between diabetic and non-diabetic patients. Despite neuropathy is a well known manifestation of diabetes; phrenic nerve damage rate is similar in diabetic patients with non-diabetic counterparts.
Table-1 Comparison of diabetic and non-diabetic patientsDiabetic group (n = 78) Non-diabetic group (n = 415) p value Age, (years) 64.38 ±10.12 58.91 ±11.84 <0.001* Gender, female (%) 45 (57 %) 207 (49.8 %) 0.267 Follow up, (months) 29.5 (6-59) 28 (6-58) 0.987 Hypertension, n (%) 57 (73%) 191 (46 %) <0.001 StrokeTIA, n(%) 4 (5.1 %) 8 (1.9 %) 0.104 Coronary artery disease, n (%) 39 (50 %) 176 (42.4 %) 0.242 AF type, Paroxysmal, (%) 65.7 % 71% 0.367 LV EF, % 59.81 ± 8.44 61.82 ± 6.89 0.027* LV end diastolic diameter, cm 4.90 ± 0.49 4.82 ± 0.46 0.160 LA diameter, cm 3.88 ± 0.51 3.81± 0.58 0.361 Recurrence 8 (10.2 %) 53 (12.7 %) 0.708 Phrenic nerve damage, n (%) 0 (0 %) 17 (4.1 %) 0.088 Inguinal hematoma, n (%) 7 (8.9%) 44 (10.6 %) 0.647 Pseudoaneurysm, n(%) 1 ( 1.2%) 3 ( 0.7 %) 0.502
