Atrial Fibrillation in Patients With Concomitant Diabetes Mellitus – What Do We Already Know and What Do We Need to Discover?

Recently published data indicate the prevalence of atrial fibrillation, the most common cardiac arrhythmia worldwide, in up to 20% of the elderly population. This arrhythmia significantly impacts the quality of life by increasing the risk of stroke, thromboembolism, dementia or heart failure, resulting in a substantial increase in the risk of adverse events and all-cause death. On the other hand, diabetes mellitus is the most predominant metabolic disorder on the globe, which incidence is surging annually, currently affecting over 500 million individuals. Patients with coexisting diabetes have a relevantly elevated risk of atrial fibrillation development. This association have not yet been comprehensively elucidated. Nonetheless, it seems to be a multifactorial, complex relationship comprising mechanisms such as oxidative stress, insulin resistance, hemostasis and fibrinolysis disturbances or endothelium dysfunction, which lead to mechanical and electrical left atrial remodeling. Therefore, this study aims to summarize the evidence regarding the relationship linking diabetes mellitus and atrial fibrillation.