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Effect of Insulin Resistance on Recurrence after Radiofrequency Catheter Ablation in Patients with Atrial Fibrillation

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A Correction to this article was published on 21 March 2022

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Abstract

Background

Whether there are many risk factors for recurrence of atrial fibrillation (AF) after ablation is unclear. The aim of this study was to investigate the relationship between insulin resistance (IR) and AF recurrence in patients without diabetes who underwent catheter ablation.

Methods

This retrospective study included patients who underwent AF ablation between 2018 and 2019 at the First Affiliated Hospital of Zhengzhou University. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated, and a value of ≥2.69 was defined as IR. The patients were divided into two groups (group 1 HOMA-IR < 2.69, n = 163; group 2 HOMA-IR ≥ 2.69, n = 69). AF recurrence was defined as the occurrence of atrial arrhythmias of more than 30 s after the first 3 months. Univariate and multivariable Cox regression models were used to analyse the risk of AF recurrence.

Results

Overall, 232 patients were enrolled (mean age, 59.9 ± 10.2 years old; female, 37.5%; paroxysmal AF, 71.6%). We found that dyslipidaemia, antiarrhythmic drug use, fasting blood glucose and fasting insulin were significantly higher in the IR group (P < 0.05). During the follow-up 1 year after ablation, 62 (26.7%) patients experienced AF recurrence. After adjusting for traditional risk factors, multivariable analysis showed that the HOMA-IR value (HR 1.259, 95% CI 1.086–1.460, P = 0.002) and left atrial diameter (LAD; HR 1.043, 95% CI 1.005–1.083, P = 0.026) were independently associated with AF recurrence.

Conclusions

The present results provide evidence that IR patients are more likely to experience AF recurrence. Improving IR status may be a potential target for reducing the postoperative recurrence rate.

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Data Availability

The data supporting the findings of this study are available on request.

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Funding

This study was partly supported by the National Key Research and Development Program (2016YFC1301000), awarded to Dr. Jianzeng Dong, MD, PhD.

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Authors and Affiliations

  1. Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China

    Zhe Wang & Yi-Jia Wang

  2. Department of Cardiology, China-Japan Friendship Hospital, No.2 East Yinghua Road, Beijing, 100029, Chaoyang District, China

    Zhe Wang & Yi-Hong Sun

  3. Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Erqi District, Zhengzhou, 450052, Henan, China

    Zhi-Yu Liu, Ya-Wei Kong, Ying-Wei Chen & Jian-Zeng Dong

  4. Department of Cardiology, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, 100029, China

    Qing Li

  5. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, 100029, Beijing, China

    Jian-Zeng Dong

Authors
  1. Zhe Wang
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  2. Yi-Jia Wang
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Contributions

ZW: Designed the study and wrote the manuscript. YJW, ZYL, and QL: Contributed to writing of the manuscript. YWK: Participated in data analysis. YWC and YHS: Supervised the data acquisition, data analysis and interpretation. JZD: Verified the data extraction and reviewed the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Ying-Wei Chen or Yi-Hong Sun.

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The authors declare that they have no conflicts of interest.

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Informed consent was obtained from all individual participants included in the study.

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Wang, Z., Wang, YJ., Liu, ZY. et al. Effect of Insulin Resistance on Recurrence after Radiofrequency Catheter Ablation in Patients with Atrial Fibrillation. Cardiovasc Drugs Ther 37, 705–713 (2023). https://doi.org/10.1007/s10557-022-07317-z

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  • DOI: https://doi.org/10.1007/s10557-022-07317-z

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