AUTHOR=Peng Zhan , Zhao Rui , Liu Yuhua , Yang Yunxiao , Yang Xiubin , Hua Kun 

TITLE=Effect of Preablation Glycemic Control on Outcomes of Atrial Fibrillation Patients With Diabetes Mellitus Following Valvular Surgery Combined With the Cox-Maze IV Procedure

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.898642

DOI=10.3389/fcvm.2022.898642

ISSN=2297-055X

ABSTRACT=Abstract
Background: 
This study was performed to assess the effect of preablation glycemic control on atrial fibrillation recurrence rates after heart valve surgery concomitant with Cox-Maze Ⅳ ablation.
Methods: 
Twelve-month preablation trends in glycemic control were studied. Recurrence and clinical outcome data were obtained during a mean follow-up period of 36.7±23.3 months postablation.
Results: 
Higher glycated hemoglobin (HbA1c) at the time of ablation was associated with higher postablation recurrence rates. The cumulative atrial fibrillation recurrence-free survival of patients with HbA1c ≥7.5% at the time of operation at 12, 24, 36 and 48 months was 97.1%, 78.3%, 54.2% and 36.3%, respectively (P < 0.001), and 100%, 84.9%, 37.2% and 16.2% for patients who preoperatively had an upward trend in HbA1c , respectively(P < 0.001).
Conclusion: 
Maintaining a downward trend in HbA1c during the 12-month period before the operation and an HbA1c value less than 7.5% at the time of the operation reduced the recurrence of AF among patients who underwent heart valve surgery concomitant with the Cox-Maze Ⅳ procedure.