Atrial fibrillation prevalence and predictors in patients with diabetes: a cross-sectional screening study

Prevalence of cardiovascular and other selected diseases among Greenlanders with and without type 2 diabetes

This study aims to estimate the prevalence of cardiovascular disease, kidney disease, and other selected diseases including hypertension, atrial fibrillation, asthma, chronic obstructive lung disease, osteoarthritis, osteoporosis, psoriasis and depression among Greenlanders living in Nuuk with and without type 2 diabetes (T2D). The study was designed as a cross-sectional case-control study based on data from the electronic medical record (EMR) in Greenland. Persons with a registered T2D diagnosis in EMR and residence in Nuuk (N = 435) were included. The prevalence of cardiovascular disease was 17.9% among persons with T2D and significantly higher compared to the control group (10.1%). In addition, our results showed a significantly higher prevalence of ischaemic heart disease, hypertension, heart failure, atrial fibrillation, osteoarthritis and psoriasis among persons with T2D compared to the control group.Our study found a higher prevalence in five out of 10 selected diseases in regularly followed persons with T2D in Nuuk compared to unselected controls. This enlightens the importance of a broad multifaceted approach in combination of changing primary health care to focus on early detection of controllable risk factors and chronic conditions care in Artic Greenland.

Accuracy and Functionality of Select Continuous Glucose Monitoring Systems Are Not Impacted by Implantable Cardioverter Defibrillator Devices

BACKGROUND

Increasing numbers of individuals with diabetes are adopting use of continuous glucose monitoring (CGM) in their daily self-management. Many of these individuals have advanced heart disease. Implantable cardioverter defibrillator (ICD) devices can effectively reduce arrhythmic death and all-cause mortality in individuals with advanced heart disease. However, the potential impact of ICD devices on CGM system accuracy and functionality has not been well studied.

METHODS

This evaluation assessed whether FreeStyle Libre (FL) CGM systems can coexist and function within the same patient in the presence of wireless interference devices, including current ICD devices. Interferer sources included Wi-Fi devices, Bluetooth devices, cellular mobile devices, implantable medical devices, Bluetooth Low-Energy (BLE) devices, BLE accessory devices and BLE mobile devices, and ICD-programmer interferers. Five testing methodologies were used to evaluate the accuracy and functionality of the CGM systems when exposed to ICD functions: high-energy emergency shocking, pacing modes, anti-tachycardia pacing mode (ATP), and DC Fibber mode.

RESULTS

All acceptance criteria and testing requirements were met for the CGM and ICD system for wireless coexistence evaluation.

CONCLUSIONS

Our findings demonstrated that coexisting ICD devices and FL CGM systems provide safe and effective wireless communications with functional and accurate transfer of data during scenarios expected in clinical use.

Surgical ablation for atrial fibrillation: impact of Diabetes Mellitus type 2

BACKGROUND

Diabetes mellitus (DM) type 2 is an independent risk factor for atrial fibrillation (AF). Surgical ablation or "maze procedure" is an option for patients with AF undergoing concomitant or isolated cardiac surgery. The aim of this study was to evaluate the impact of DM type 2 on early and long-term outcomes of patients following surgical AF ablation.

METHODS

We performed an observational cohort study in Israel's largest tertiary care center. All data of patients who underwent surgical AF ablation, between 2006 and 2021 were extracted from our departmental database. Patients were divided into Group I (non-diabetic patients) and Group II (DM type 2 patients). We compared the two groups with respect to freedom from recurrent atrial arrhythmia, and mortality rate.

RESULTS

The study population included 606 patients. Group I (non-DM patients), consisting of 484 patients, and Group II (DM type 2 patients), comprised 122 patients. Patients with DM were older, had more hypertension and incidence of cerebrovascular accident (CVA)/transient ischemic attack (TIA), higher EuroSCORE (p < .05 for all), and a longer bypass time-130 ± 40 vs. 122 ± 36 min (p = 0.028). The mean follow-up duration was 39.0 ± 22.7 months. Freedom from atrial fibrillation was similar between the non-DM and DM type 2 groups after a 1-year follow-up, 414 (88.2%) vs. 101 (87.1%) (p = 0.511), after a 3-year follow-up, 360 (86.3%) vs. 84 (79.9%) (p = 0.290) and after a 5-year follow-up, 226 (74.1%) vs. 55 (71.5%) (p = 0.622) respectively. Furthermore, 1- and 3-year mortality was similar between non-DM and DM type 2 groups, 2.5% vs. 4.9%, (p = 0.226) and 5.6% vs. 10.5% (p = 0.076) respectively. 5-year mortality was higher in Group II (DM type 2 patients) compared with Group I (non-DM patients), 11.1% vs. 23.4% (p = 0.009).

CONCLUSION

Surgical ablation had a high success rate, with freedom from recurrent atrial arrhythmia at 1- 3- and 5- years follow-up in both the DM type 2 and non-DM groups. Furthermore,1- and 3-year mortality after surgical ablation was also similar in both groups. However, 5-year mortality was higher in the DM type 2 group.