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QJM Advance Access published online on January 17, 2008
QJM, doi:10.1093/qjmed/hcm123
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© The Author 2007. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Influence of diabetes on the maintenance of sinus rhythm after a successful direct current cardioversion in patients with atrial fibrillation

H. Soran1, N. Younis2, P. Currie3, J. Silas3, I.R. Jones4 and G. Gill5

From the 1Department of Medicine, Central Manchester University Hospitals, 2Department of Diabetes and Endocrinology, South Manchester University Hospitals, Manchester, 3Department of Cardiology, 4Department of Diabetes and Endocrinology, Wirral Hospitals NHS trust, Wirral, Cheshire and 5University Department of Medicine, University Hospital Aintree, Liverpool, UK

Address correspondence to Dr Handrean Soran, Consultant Physician, Department of Endocrinology, Central Manchester University Hospitals, Oxford road, Manchester, M13 9WL, UK. email: handrean.soran{at}cmmc.nhs.uk

Received 28 April 2007 and in revised form 9 August 2007


  Abstract

Aim: To determine independent risk factors for recurrence of atrial fibrillation (AF) after a successful direct current (DC) cardioversion in patients with and without diabetes.

Design: We retrospectively analysed the outcome in patients recently diagnosed with persistent AF.

Methods: Of 364 patients included, 289 had a successful direct current (DC) cardioversion. We compared 42 (14.5%) patients known to have diabetes to 247 (85.5%) without. Patients were reviewed in outpatient clinic with assessment of heart rhythm clinically and by electrocardiogram. Median follow-up after DC cardioversion was 74 days [interquartile range (IQR) 69–78 days].

Results: When reviewed in outpatient clinic, only 63.7% (185 of 289) were still in sinus rhythm (SR). Of the group without diabetes, 66.8% (165 of 247) remained in SR vs. 45.2% (19 of 42) of the group with diabetes (P = 0.005). Binary logistic regression analysis showed duration of AF (P < 0.0001) and the presence of diabetes (P = 0.019) have been independent risk factors for recurrence of AF.

Discussion: Presence of diabetes and the longer duration of AF were independent risk factors for the recurrence of AF after a successful DC cardioversion.


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