Type 2 diabetes mellitus independently increased the odds of atrial tachyarrhythmia recurrence (OR 1.843) and adverse cardiovascular events (OR 2.148) in patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation.
Cohort (n=748)
No
Does the presence of type 2 diabetes mellitus increase the risk of atrial tachyarrhythmia recurrence and adverse cardiovascular events in patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation?
In patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation, the presence of type 2 diabetes mellitus is an independent predictor of both atrial tachyarrhythmia recurrence and adverse cardiovascular events.
Effect estimate: OR 1.843 (95% CI 1.116-3.406)
Absolute Event Rate: 24% vs 15%
p-value: p=0.030
Abstract Background Type 2 diabetes mellitus (T2DM) is a modifiable risk factor both for atrial fibrillation (AF) and for the development of cerebrovascular-events in patients with AF. The aim of our study was to determine the effect of cryoballoon ablation (CBA) treatment on long-term atrial-tachyarrhythmia recurrence and adverse cardiovascular (CV) events in paroxysmal AF patients with T2DM. Methods This retrospective-observational-cohort study included 748-patients (406-male,342-female,59.4 ± 11.8years) who underwent CBA with a diagnosis of paroxysmal AF between 2013−2023. The primary endpoint was atrial tachyarrhythmia recurrence (After-CBA≥3months) and the secondary endpoint was development of CV-events (CV mortality, non-fatal myocardial infarction and cerebrovascular-events). All patients were followed up for at least 24 months for atrial-tachyarrhythmia recurrence and CV event development. Results The prevalence of T2DM was 26% in patients who underwent CBA. Atrial-tachyarrhythmia recurrence and CV events were more frequent in the T2DM group (24%vs15%, p = 0.004 and 33%vs9%, p = 0.045, respectively). Systolic-diastolic blood pressure, female gender, frequency of T2DM and anti-diabetic drug use, and left atrial diameter (LAd) values were higher in patients with atrial-tachyarrhythmia recurrence ( p < 0.05). The presence of LAd and T2DM were shown to independently predict the development of atrial-tachyarrhythmia recurrence (OR = 1.235,95%CI-1.169-1.305, p < 0.001andOR = 1.843,95%CI-1.116-3.406, p = 0.030). Male-gender and presence of T2DM, CHA 2 DS 2 -VA score and uric-acid were shown to independently predict CV events (OR = 1.906,95%CI1.102-3.299, p = 0.021,OR = 2.148,95%CI-1.073-4.303, p = 0.013,OR = 1.613,95%CI-1.346-1.932, p = 0.001andOR = 1.322,95%CI-1.125-1.554, p = 0.001). Conclusion The presence of T2DM is an important, independent and modifiable risk factor for both atrial-tachyarrhythmia recurrence and adverse CV events in patients treated with CBA for AF. It was concluded that comprehensive management of T2DM is necessary to improve long-term outcomes of CBA. Graphical Abstract
Ardıç et al. (2026) conducted a cohort in Paroxysmal atrial fibrillation (n=748). Cryoballoon ablation (in patients with Type 2 diabetes mellitus) vs. Cryoballoon ablation (in patients without Type 2 diabetes mellitus) was evaluated on Atrial tachyarrhythmia recurrence (≥3 months after ablation) (OR 1.843, 95% CI 1.116-3.406, p=0.030). Type 2 diabetes mellitus independently increased the odds of atrial tachyarrhythmia recurrence (OR 1.843) and adverse cardiovascular events (OR 2.148) in patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation.