title: Catheter ablation of atrial fibrillation and atrial flutter in patients with diabetes mellitus: Who benefits and who does not? Data from the German ablation registry.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Märkische Kliniken GmbH, Klinikum Lüdenscheid, Lüdenscheid, Germany; Department of Cardiology, University Witten/Herdecke, Witten, Germany. Electronic address: Harilaos.bogossian@klinikum-luedenscheid.de.
authors.forename: Harilaos
authors.initials: H
authors.lastname: Bogossian
authors.affiliation: Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital, Muenster, Germany.
authors.forename: Gerrit
authors.initials: G
authors.lastname: Frommeyer
authors.affiliation: Department of Cardiology, Hospital Coburg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Brachmann
authors.affiliation: Klinik für Kardiologie und Internistische Intensivmedizin, Peter Osypka Herzzentrum Kliniken Dr. Müller, München, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Lewalter
authors.affiliation: Klinik für Kardiologie und Internistische Intensivmedizin, Klinikum München-Bogenhausen, München, Germany.
authors.forename: Ellen
authors.initials: E
authors.lastname: Hoffmann
authors.affiliation: Department of Cardiology, Asklepios Hospital St. Georg, Hamburg, Germany.
authors.forename: Karl Heinz
authors.initials: KH
authors.lastname: Kuck
authors.affiliation: Evangelische Elisabeth-Klinik, Berlin, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Andresen
authors.affiliation: University Heart Center, Department of Cardiology and Electrophysiology, Hamburg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Willems
authors.affiliation: Brandenburgische Technische Universität (BTU) Cottbus-Senftenberg, Germany; Praxisklinik Herz und Gefäße - Akademische Lehrpraxisklinik der TU Dresden, Dresden, Germany.
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Spitzer
authors.affiliation: Clinic for Interventional Electrophysiology and Ruhr-University Bochum Heart Center, Bad Neustadt, Bavarian, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Deneke
authors.affiliation: Department of Cardiology, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Dierk
authors.initials: D
authors.lastname: Thomas
authors.affiliation: Stiftung Institut fuer Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hochadel
authors.affiliation: Stiftung Institut fuer Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.affiliation: Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital, Muenster, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Eckardt
authors.affiliation: Märkische Kliniken GmbH, Klinikum Lüdenscheid, Lüdenscheid, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Lemke
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000601:surgery*; D001282:Atrial Flutter / Q000453:epidemiology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods / Q000706:statistics & numerical data*; D048909:Diabetes Complications / Q000453:epidemiology / Q000601:surgery*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome
keywords: Atrial fibrillation; Diabetes mellitus; Registry; Right atrial flutter