Impact of Diabetes on the Efficacy of Low‐Voltage Area Ablation for Persistent Atrial Fibrillation: A Subanalysis of the SUPPRESS‐AF Trial

作者：Tatsuhisa Ozaki, Koichi Inoue, Tsuyoshi Mishima, Takuya Ohashi, Satoshi Osaki, Yasunori Ueda, Masaharu Masuda, Akihiro Sunaga, Nobuaki Tanaka, Tetsuya Watanabe, Hitoshi Minamiguchi, Yasuyuki Egami, Takafumi Oka, Tomoko Minamisaka, Takashi Kanda, Masato Okada, M Kawasaki, Yasuhiro Matsuda, Koji Tanaka, Nobuhiko Makino, Hirota Kida, Shungo Hikoso, Tomoharu Dohi, Yohei Sotomi, Yasushi Sakata, Masaharu Masuda, Yasuhiro Matsuda, H Uematsu, T Tsujimura, Hirotaka Ooka, Satoshi Kudo, Takashi Sumigawa, Akihiro Sunaga, Yuki Matsuoka, Daisaku Nakatani, Katsuki Okada, Hirota Kida, Daisuke Sakamoto, Tetsuhisa Kitamura, Takafumi Oka, Tomoaki Nakano, Takayuki Sekihara, Tomoharu Dohi, Tomomi Yamada, Shungo Hikoso, Yohei Sotomi, K Nishio, Yasushi Sakata, Nobuaki Tanaka, Yuko Hirao, Koji Tanaka, Masato Okada, K Iwasa, Yusuke Ikada, Tomoko Minamisaka, Tetsuya Watanabe, Nobutaka Masunaga, Yukinori Shinoda, Norioki Inui, Ryohei Amiya, Masato Fujiwara, A Murakami, Hitoshi Minamiguchi, Yoshiharu Higuchi, Yasuhiro Ichibori, Naoki Mori, Takashi Kanda, Yuma Hamanaka, Yumi Tsutsui, Mikiko Matsumura, Takashige Sakio, Satoshi Nakawatase, Yuki Shibuya, Shinya Minami, Koichi Ochi, Ken Koda, Naoya Kurata, Hiroshi Kobayashi, Yasuyuki Egami, Masamichi Yano, 松永泰治, Koji Yasumoto, Kohei Ukita, Mizuki Osuga, Noriyuki Kobayashi, Ayako Sugino, Atsushi Shiono, M Kawasaki, Mitsutoshi Asai, Atsushi Kikuchi, Takumi Kondo, Tsutomu Kawai, M Seo, Atsushi Nakamura, Takeshi Fujita, Takuya Omoto, Yuki Kokubu, Yuto Fukuda, Hirota Kida, Yoshitaka Kikuchi, K Inoue, Tsuyoshi Mishima, Tatsuhisa Ozaki, Takuya Ohashi · 发表于：Journal of the American Heart Association · 年份：2026 · DOI：10.1161/jaha.125.047450 · 被引用次数：1 · 研究领域：Atrial Fibrillation Management and Outcomes、Cardiac Arrhythmias and Treatments、Cardiac pacing and defibrillation studies

Background The potential value of low‐voltage area (LVA) ablation for persistent atrial fibrillation (AF) has been suggested. However, its efficacy determinants remain unclear. We investigated the impact of diabetes on the outcomes of LVA ablation in patients with persistent AF. Methods This post hoc subanalysis of the multicenter randomized controlled trial SUPPRESS‐AF (Efficacy and Safety of Low‐Voltage‐Guided Ablation for Recurrence Prevention Compared With Pulmonary Vein Isolation Alone in Patients With Persistent Atrial Fibrillation) included patients with persistent AF undergoing initial ablation. Following pulmonary vein isolation (PVI), patients with LVAs were randomized to PVI+LVA‐ablation or PVI alone. We compared recurrence‐free survival between patients with and without diabetes. The primary end point was freedom from AF/atrial tachycardia recurrence. Results Of 1347 patients with persistent AF, 343 (25.5%) had left atrial LVAs. The nondiabetic group comprised 264 patients (136 and 128 in the PVI‐alone and PVI+LVA‐ablation arms, respectively), and the diabetic group comprised 77 patients (35 and 42 in each arm, respectively). No significant difference was observed in LVA extent between the groups. Overall recurrence rates were also similar (44% versus 42%; P =0.658). In the nondiabetic group, the PVI+LVA‐ablation arm showed significantly lower recurrence rates compared with the PVI‐alone arm (35% versus 49%; P =0.018). Conversely, patients with diabetes exhibited ...