title: 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.
abstract: BACKGROUND
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cardiac Arrhythmia and Heart Failure Research Center, St. Camillo-Forlanini Hospital, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Forleo
authors.forename: Massimo
authors.initials: M
authors.lastname: Mantica
authors.forename: Lucia
authors.initials: L
authors.lastname: De Luca
authors.forename: Roberto
authors.initials: R
authors.lastname: Leo
authors.forename: Luca
authors.initials: L
authors.lastname: Santini
authors.forename: Stefania
authors.initials: S
authors.lastname: Panigada
authors.forename: Valerio
authors.initials: V
authors.lastname: De Sanctis
authors.forename: Augusto
authors.initials: A
authors.lastname: Pappalardo
authors.forename: Francesco
authors.initials: F
authors.lastname: Laurenzi
authors.forename: Andrea
authors.initials: A
authors.lastname: Avella
authors.forename: Michela
authors.initials: M
authors.lastname: Casella
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
authors.forename: Gemma
authors.initials: G
authors.lastname: Pelargonio
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications* / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000628:therapy*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents