Insulin resistance and atrial fibrillation: from disease onset to post-ablation outcomes: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational cohort studies
PubMed 41584292 · doi:10.3389/fcvm.2025.1700730
What was done
Authors conducted a systematic review and meta-analysis (PROSPERO CRD420251142441) of 30 cohort studies from multiple countries. They assessed the association between insulin resistance markers (such as TyG index and HOMA-IR) and both new-onset atrial fibrillation (AF) and post-ablation AF recurrence using random-effects models, subgroup analyses, meta-regression, and GRADE assessment.
What was found
Insulin resistance was significantly associated with higher risk of new-onset AF (HR = 1.34, 95% CI: 1.24-1.46) and post-ablation recurrence (HR = 1.57, 95% CI: 1.39-1.78). Subgroup and sensitivity analyses showed consistent effects, with evidence quality rated as moderate under GRADE.
Why it matters
Markers of insulin resistance may serve as useful clinical indicators for risk stratification in primary AF prevention and post-ablation management.
Limits
All included studies were observational cohorts, limiting causal conclusions. The abstract does not provide the total number of individual participants, specific follow-up durations, or statistical heterogeneity metrics.
Cited by
- supports Metabolic disease and inflammation driven by blood sugar or insulin cause atrial muscle components to alter their conduction, causing atrial fibrillation.