Diabetes and Atrial Fibrillation: Insight From Basic to Translational Science Into the Mechanisms and Management

In spite of significant progress made in the management in recent decades, atrial fibrillation (AF) continues to cause increased mortality and significant morbidities, including heart failure and stroke. Diabetes mellitus (DM) is an independent risk factor for AF, and adds risks to increased mortality and hospitalizations when present along with AF. The pathophysiology of AF related to DM is complex with many inter-related factors. Atrial cardiomyopathy (atriopathy) related to structural changes from subcellular abnormalities and fibrosis, coupled with cardiac mechanical dysfunction, abnormal ion expression, dysregulation of the renin-angiotensin-aldosterone system and the autonomic nervous system function, play crucial roles in genesis and progression of AF. In this review, we discuss insights from basic to translational science into the mechanisms and management related to AF associated with DM.