Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama, Japan.
Department of Cardiology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan.
Sci Rep. 2023 Mar 15;13(1):4299. doi: 10.1038/s41598-023-31139-0.
Although glucose metabolism and atrial fibrillation (AF) have complex interrelationships, the impact of catheter ablation of AF on glucose status has not been well evaluated. Continuous glucose monitoring (CGM) with a FreeStyle Libre Pro (Abbott) was performed for 48 h pre-procedure, during the procedure, and for 72 h post-procedure in 58 non-diabetes mellitus (DM) patients with symptomatic AF and 20 patients with supraventricular or ventricular arrhythmias as a control group. All ablation procedures including pulmonary vein isolation were performed successfully. Glucose levels during procedures consistently increased in the AF and control groups (83.1 ± 16.1 to 110.0 ± 20.5 mg/dL and 83.3 ± 14.7 to 98.6 ± 16.3 mg/dL, respectively, P < 0.001 for both), and Δ glucose levels (max minus min/procedure) were greater in the AF group than control group (P < 0.001). There was a trend toward higher mean glucose levels at 72 h after the procedures compared with those before the procedures in both the AF and control groups (from 103.4 ± 15.6 to 106.1 ± 13.0 mg/dL, P = 0.063 and from 100.2 ± 17.1 to 102.9 ± 16.9 mg/dL, P = 0.052). An acute increase in glucose level at the time of early AF recurrence (N = 9, 15.5%) could be detected by simultaneous CGM and ECG monitoring (89.7 ± 18.0 to 108.3 ± 30.5 mg/dL, P = 0.001). In conclusion, although AF ablation caused a statistically significant increase in the glucose levels during the procedures, it did not result in a pathologically significant change after ablation in non-DM patients. Simultaneous post-procedure CGM and ECG monitoring alerted us to possible acute increases in glucose levels at the onset of AF recurrence.
尽管葡萄糖代谢与心房颤动（AF）之间存在复杂的相互关系，但导管消融 AF 对血糖状态的影响尚未得到充分评估。我们对 58 例有症状 AF 患者和 20 例室上性或室性心律失常患者进行了连续血糖监测（CGM），在术前、术中及术后 72 小时内使用 FreeStyle Libre Pro（雅培）进行监测。所有消融程序（包括肺静脉隔离）均成功进行。AF 组和对照组的血糖水平在术中持续升高（分别从 83.1±16.1 至 110.0±20.5mg/dL 和 83.3±14.7 至 98.6±16.3mg/dL，均 P<0.001），且 AF 组的 Δ血糖水平（最大值减去最小值/手术）高于对照组（P<0.001）。AF 组和对照组术后 72 小时的平均血糖水平均高于术前（分别从 103.4±15.6 至 106.1±13.0mg/dL，P=0.063 和从 100.2±17.1 至 102.9±16.9mg/dL，P=0.052）。通过同步 CGM 和 ECG 监测，可在 AF 早期复发时（N=9，15.5%）检测到葡萄糖水平的急性升高（89.7±18.0 至 108.3±30.5mg/dL，P=0.001）。总之，尽管 AF 消融术会导致术中血糖水平出现统计学上的显著升高，但在非糖尿病患者中，消融后并未导致血糖水平发生病理性显著变化。术后同步 CGM 和 ECG 监测可提醒我们在 AF 复发时可能出现血糖水平的急性升高。
