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QTc interval predicts outcome of catheter ablation in paroxysmal atrial fibrillation patients with type 2 diabetes mellitus

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Abstract

Catheter ablation has been recommended as a treatment option for paroxysmal atrial fibrillation (PAF) patients complicated with type 2 diabetes mellitus (T2DM). PAF patients with T2DM have a higher recurrence rate after catheter ablation. Prolongation of corrected QT (QTc) interval has been linked to poor outcomes in T2DM patients. Whether the abnormal QTc interval is associated with the ablation outcome in the PAF patients with T2DM remains unknown. In this study, 134 PAF patients with T2DM undergoing primary catheter ablation were retrospectively enrolled. Pre-procedural QTc interval was corrected by using the Bazett’s formula. Cox proportional hazards models were constructed to assess the relationship between QTc interval and the recurrence of AF. After a 29.1-month follow-up period, 61 patients experienced atrial tachyarrhythmia recurrence. Recurrent patients had a longer QTc interval than non-recurrent patients (425.2±21.5 ms vs. 414.1±13.4 ms, P=0.002). Multivariate Cox regression analysis revealed that QTc interval [hazard ratio (HR)=1.026, 95% confidence interval (CI) 1.012–1.040, P=0.005] and left atrial diameter (LAD) (HR=1.125, 95% CI 1.062–1.192, P=0.003) were independent predictors of recurrent atrial tachyarrhythmia. Receiver operating characteristic analysis demonstrated that the cut-off value of QTc (418 ms) predicted arrhythmia recurrence with a sensitivity of 55.7% and a specificity of 69.9%. A combination of LAD and QTc was more effective than LAD alone (P<0.001) in predicting arrhythmia recurrence after the procedure. QTc interval could be used as an independent predictor of arrhythmia recurrence in T2DM patients undergoing AF ablation, thus providing a simple method to identify those patients who likely have a better outcome following the procedure.

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Authors and Affiliations

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

    Ning Ma  (马 宁), Xiao-yan Wu  (吴晓燕), Chang-sheng Ma  (马长生), Nian Liu  (刘 念), Rong Bai  (白 融), Xin Du  (杜 昕), Yan-fei Ruan  (阮燕菲) & Jian-zeng Dong  (董建增)

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  1. Ning Ma  (马 宁)
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  2. Xiao-yan Wu  (吴晓燕)
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  3. Chang-sheng Ma  (马长生)
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  4. Nian Liu  (刘 念)
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  5. Rong Bai  (白 融)
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  6. Xin Du  (杜 昕)
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  7. Yan-fei Ruan  (阮燕菲)
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  8. Jian-zeng Dong  (董建增)
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Correspondence to Jian-zeng Dong  (董建增).

Additional information

This study was supported by grants from the Ministry of Science and Technology of the People’s Republic of China (No. 2013BAI09B02 and No. 2013DFB30310), Beijing Municipal Commission of Science and Technology (No. D131100002- 313001), and the National Science Foundation Council of China (Nos. 81170168, 81370290, 81370292 and 81470465).

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Ma, N., Wu, Xy., Ma, Cs. et al. QTc interval predicts outcome of catheter ablation in paroxysmal atrial fibrillation patients with type 2 diabetes mellitus. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 36, 646–652 (2016). https://doi.org/10.1007/s11596-016-1640-5

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  • DOI: https://doi.org/10.1007/s11596-016-1640-5

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