2016


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2016/№4

Predictors of atrial flutter relapse following radiofrequency ablation of cavotricuspid isthmus in patients with type 2 diabetes mellitus

Kachanova Yu. A.1, Marfunina A. A.2, Novikova N. A.1, Syrkin A. L.1
1 – State Budgetary Educational Institution of Higher Professional Education, “I. M. Sechenov First Moscow State Medical University” of the RF Ministry of Health Care, Trubetskaya 8, Bldg. 2, Moscow 119991
2 – State Budgetary Health Care Institution “Municipal Hospital #4 of the Moscow Health Care Department”, Pavlovskaya 25, Moscow 115093

Keywords: comorbidity, treatment, radiofrequency ablation, type 2 diabetes mellitus, atrial fibrillation

DOI: 10.18087/rhj.2016.4.2262

Background. Correction of heart rhythm disorders (atrial fibrillation/flatter) in patients with comorbidities is an extremely important issue of current medical practice. However, Russian and international reports on identification of predictors for atrial flutter (AF) in patients with DM after radiofrequency ablation of cavotricuspid isthmus (RFA CTI) are practically absent. A deep insight into RFs for AF relapse and possible prevention is required. Aim. To identify RFs for AF following this procedure. Materials and methods. The study included 100 patients with DM and AF after RFA. EchoCG, 24-h Holter ECG monitoring (24-h ECGM), measurements of glycated hemoglobin (HbA1C), creatinine, and glomerular filtration rate (GFR) were performed for all patients. Patients received antiarrhythmic (sotalol), anticoagulant (warfarin, rivaroxaban, dabigatran), and antihyperglycemic (gliclazide, glimepiride, metformin, insulin) therapy for a month prior to and for 3 months after RFA. Transesophageal EchoCG (TEEchoCG) was performed for patients with constant AF a day before or on the day of surgery to exclude thrombosis in the left ventricular cavity. Results. 22 patients had AF relapse in the next year. These patients had statistically higher incidences of poor glycemic control, a history of postinfarction cardiosclerosis, and chronic kidney disease (CKD). RFA was more frequently ineffective in female patients and patients older than 75. Conclusion. In patients with DM after RFA, AF relapse is more frequently associated with poor glycemic control and DM severity presented by DM complications such as CKD. Female gender and elderly age are also predictors of AF relapse.
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Kachanova Yu. A., Marfunina A. A., Novikova N. A., Syrkin A. L. Predictors of atrial flutter relapse following radiofrequency ablation of cavotricuspid isthmus in patients with type 2 diabetes mellitus. Russian Heart Journal. 2016;15 (4):293–297

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