Author + information
- Received May 2, 2019
- Revision received June 29, 2019
- Accepted July 2, 2019
- Published online August 19, 2019.
- Allen Wang, BSa,
- Jennifer B. Green, MDb,
- Jonathan L. Halperin, MDc and
- Jonathan P. Piccini Sr., MD, MHSa,b,∗ (, )@JonPicciniSr
- aDuke Center for Atrial Fibrillation, Department of Medicine, Duke University Medical Center, Durham, North Carolina
- bDuke Clinical Research Institute, Durham, North Carolina
- cMount Sinai Hospital, New York, New York
- ↵∗Address for correspondence:
Dr. Jonathan P. Piccini, Electrophysiology Section, Duke University Medical Center, Duke Clinical Research Institute, P.O. Box 17969, Durham, North Carolina 27710.
• Diabetes mellitus is an independent risk factor for AF.
• The complex underlying pathophysiology is related to structural, electrical, electromechanical, and autonomic remodeling.
• Glucose-lowering therapies may affect development of AF.
• Further research is needed to determine the optimal stroke prevention and long-term rhythm control strategies for AF patients with diabetes.
Diabetes mellitus is one of the most common chronic medical conditions, and is a risk factor for the development of atrial fibrillation (AF). The presence of diabetes in patients with AF is associated with increased symptom burden and increased cardiovascular and cerebrovascular mortality. The pathophysiology of diabetes-related AF is not fully understood, but is related to structural, electrical, electromechanical, and autonomic remodeling. This paper reviews the complex interaction between diabetes and AF, and explores its effect on the prevention and treatment of AF.
Dr. Green has received grants to her institution from AstraZeneca, Boehringer Ingelheim, Sanofi, Boehringer Ingelheim/Lilly Alliance, and GlaxoSmithKline; and has served as a consultant for AstraZeneca, Boehringer Ingelheim, Boehringer Ingelheim/Lilly Alliance, Novo Nordisk, and Merck. Dr. Halperin has received funding from Bayer, Boehringer Ingelheim, Medtronic, Janssen, and Pfizer. Dr. Piccini has received grants for clinical research from Abbott, American Heart Association, Boston Scientific, Gilead, Janssen Pharmaceuticals, and the National Heart, Lung, and Blood Institute; and has served as a consultant to Abbott, Allergan, ARCA Biopharma, Bayer, Biotronik, LivaNova, Medtronic, Milestone, Motif Bio, Sanofi, Philips, and Up-to-Date. Dr. Wang has reported that he has no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received May 2, 2019.
- Revision received June 29, 2019.
- Accepted July 2, 2019.
- 2019 American College of Cardiology Foundation
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