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Published on: February 26, 2013

Diabetes influences the cardiac symptoms related to atrial fibrillation

Kazuro Sugishita1, Etsuko Shiono, Takao Sugiyama

  • 1Division of Cardiovascular Diseases, Institute for Adult Diseases Asahi Life Foundation, Tokyo, Japan. k-sugishita@jrtokyohosp.gr.jp

Circulation Journal : Official Journal of the Japanese Circulation Society
|October 28, 2003
PubMed

Insights

Diabetes mellitus (DM) may mask the symptoms of atrial fibrillation (AF). This study found fewer symptomatic AF episodes in diabetic patients, potentially due to diabetic neuropathy.

Area of Science:

  • Cardiology
  • Endocrinology
  • Neurology

Background:

  • Diabetes mellitus (DM) is known to mask cardiac symptoms during myocardial infarction.
  • The influence of DM on subjective symptoms during atrial fibrillation (AF) episodes remains underreported.

Purpose of the Study:

  • To investigate whether diabetes mellitus affects the subjective symptom experience of atrial fibrillation.

Main Methods:

  • Retrospective assessment of 65 patients with paroxysmal AF.
  • Comparison of symptomatic status and heart rate between patients with and without DM.
  • Analysis excluding patients on beta-blockers or antiarrhythmic agents.
  • Assessment of DM neuropathy prevalence in symptomatic versus asymptomatic AF patients.

Main Results:

  • Diabetic patients (n=15) showed a trend towards lower symptomatic first-recorded AF episodes compared to non-diabetic patients (n=50) (25% vs 61%, p=0.04) after excluding medication effects.
  • No significant difference in heart rate or ventricular response was observed between groups.
  • Diabetic neuropathy was significantly more prevalent in asymptomatic AF patients (70% vs 0%, p=0.01).

Conclusions:

  • Diabetes mellitus may mask the cardiac symptoms of atrial fibrillation, particularly during the first recorded episode.
  • Diabetic neuropathy is a potential contributing factor to the reduced symptom perception in diabetic patients experiencing AF.

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