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The Scientific World Journal
Volume 2013 (2013), Article ID 209428, 6 pages
http://dx.doi.org/10.1155/2013/209428
Review Article

Mechanism of and Therapeutic Strategy for Atrial Fibrillation Associated with Diabetes Mellitus

Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou 0086-510630, China

Received 11 January 2013; Accepted 19 February 2013

Academic Editors: Y. Du and Y. Wang

Copyright © 2013 Yubi Lin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Diabetes mellitus (DM) is one of the most important risk factors for atrial fibrillation (AF) and is a predictor of stroke and thromboembolism. DM may increase the incidence of AF, and when it is combined with other risk factors, the incidence of stroke and thromboembolism may also be higher; furthermore, hospitalization due to heart failure appears to increase. Maintenance of well-controlled blood glucose and low levels of HbA1c in accordance with guidelines may decrease the incidence of AF. The mechanisms of AF associated with DM are autonomic remodeling, electrical remodeling, structural remodeling, and insulin resistance. Inhibition of the renin-angiotensin system is suggested to be an upstream therapy for this type of AF. Studies have indicated that catheter ablation may be effective for AF associated with DM, restoring sinus rhythm and improving prognosis. Catheter ablation combined with hypoglycemic agents may further increase the rate of maintenance of sinus rhythm and reduce the need for reablation.