What are Arrhythmogenic Substrates in Diabetic Rat Atria?

Abstract

The present diabetic GK rat showed increased atrial arrhythmogenicity with intra-atrial conduction disturbance, and thus indicated that the structural remodeling of atrium characterized by diffuse interstitial fibrosis would be a major substrate for diabetes-related AF.

Endothelial–mesenchymal transition in human atrial fibrillation

“…Atrial structural remodeling, particularly fibrosis in which fibroblasts play a key role, is important in many forms of AF [8,9,10]. In our study population, the amount of fibrotic deposition in LA was correlated with LAD, which is a strong predictor of recurrence of AF after catheter ablation or drug therapy [2,11].…”

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

“…Diabetes promotes atrial remodeling characterized by diffuse interstitial fibrosis and conduction slowing, 335 and has been shown to be an independent risk factor for development of AF. 9,336,337 At least 10 studies have evaluated whether diabetes or impaired glucose metabolism predicts AF recurrence following ablation, with varying results.…”

Influences of Autonomic Nervous System on Atrial Arrhythmogenic Substrates and the Incidence of Atrial Fibrillation in Diabetic Heart

“…20) However, the results of studies of myocardial interstitial fibrosis in DM have varied widely. 11,29,30) Our previous study has revealed that interstitial fibrosis does not appear in the Otsuka Long-Evans Tokushima Fatty (OLETF) rat type 2 DM model. 30) Further study is needed to determine how fibrotic change could be observed in a DM animal model, and to clarify the relevance of atrial fibrosis to AF vulnerability in DM.…”

“…Accordingly, when considering the difference between other results and ours, whether or not fibrotic change is present in the atrium seems to be critical. Several experimental studies have documented that atrial fibrosis is closely associated with a propensity toward AF through slowing down the atrial conduction velocity, 11,28) especially in aged rats. 20) However, the results of studies of myocardial interstitial fibrosis in DM have varied widely.…”

“…11) Their results suggest that alterations in atrial electrophysiological properties and tissue structure may be one of the mechanisms that increases the incidence of AF in diabetic hearts. Another possible mechanism is that the abnormality of the autonomic nervous system may be related to the genesis of AF.…”