Abstract | BACKGROUND: METHODS AND RESULTS: A first CA was performed in 271 consecutive patients with DM and AF (age: 65 ± 9 years, women: 34%; and paroxysmal AF: 51%). At a median of 13 months after CA (interquartile range: 6-30), 100/182 patients (55%) treated with metformin remained in sinus rhythm without antiarrhythmic drug therapy, compared with 36/89 patients (40%) not receiving metformin (p = .03). There was a significant association between metformin therapy and freedom from recurrent atrial arrhythmias after CA in multivariable Cox hazards models (hazard ratio [HR]: 0.66; ±95% confidence interval [CI]: 0.44-0.98; p = .04) that adjusted for age, sex, body mass index, AF type (paroxysmal vs. nonparoxysmal), antiarrhythmic medication, obstructive sleep apnea, chronic kidney disease, coronary artery disease, left ventricular ejection fraction, and left atrial diameter. A Cox model that also incorporated other antidiabetic agents and fasting blood glucose demonstrated a similar reduction in the risk of recurrent atrial arrhythmias with metformin treatment (HR: 0.63; ±95% CI: 0.42-0.96; p = .03). CONCLUSIONS: In patients with DM, treatment with metformin appears to be independently associated with a significant reduction in the risk of recurrent atrial arrhythmias after CA for AF. Whether this effect is due to glycemic control or pleiotropic effects on electroanatomical mechanisms of AF remains to be determined.
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Authors | Amrish Deshmukh, Michael Ghannam, Jackson Liang, Mohammed Saeed, Ryan Cunnane, Hamid Ghanbari, Rakesh Latchamsetty, Thomas Crawford, Syeda A Batul, Eugene Chung, Frank Bogun, Krit Jongnarangsin, Frank Pelosi, Aman Chugh, Fred Morady, Elif Oral, Hakan Oral |
Journal | Journal of cardiovascular electrophysiology
(J Cardiovasc Electrophysiol)
Vol. 32
Issue 5
Pg. 1232-1239
(05 2021)
ISSN: 1540-8167 [Electronic] United States |
PMID | 33600005
(Publication Type: Journal Article)
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Copyright | © 2021 Wiley Periodicals LLC. |
Chemical References |
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Topics |
- Aged
- Atrial Fibrillation
(diagnosis, drug therapy, surgery)
- Catheter Ablation
(adverse effects)
- Female
- Humans
- Metformin
(adverse effects)
- Middle Aged
- Recurrence
- Risk Factors
- Stroke Volume
- Treatment Outcome
- Ventricular Function, Left
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