Effects of Electrical Remodeling on Atrial Fibrillation in Diabetes Mellitus

^*Correspondence: qianlingling@njmu.edu.cn (Ling-ling Qian); ruxingw@aliyun.com (Ru-Xing Wang)
^†These authors contributed equally.
Academic Editor: Celestino Sardu

Rev. Cardiovasc. Med. 2023, 24(1), 3; https://doi.org/10.31083/j.rcm2401003

Submitted: 23 August 2022 | Revised: 24 October 2022 | Accepted: 28 October 2022 | Published: 3 January 2023

(This article belongs to the Special Issue Diabetes and Cardiovascular Diseases 2022)

This is an open access article under the CC BY 4.0 license.

Abstract

Atrial fibrillation (AF) is one of the most common arrhythmias in medical practice. Diabetes mellitus (DM) is one of the independent risk factors for atrial fibrillation. The increased morbility of atrial fibrillation in diabetes mellitus is related to both structural and electrical remodeling of atrium. Based on studies of atrial electrophysiological changes in diabetes mellitus, this article focuses on the electrical remodeling of atrial cardiomyocytes, including remodeling of sodium channels, calcium channels, potassium channels and other channels, to provide the basis for the clinical management of antiarrhythmic drugs in diabetic patients with atrial fibrillation.

Keywords

atrial fibrillation

diabetes mellitus

electrical remodeling

sodium channels

calcium channels

potassium channels

late sodium channels

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Funding

82000317/National Natural Science Foundation of China

81770331/National Natural Science Foundation of China

BJ2020018/Top Talent Support Program for Young and Middle-aged People of Wuxi Health Committee

Q202034/Research Foundation from Wuxi Health Commission for the Youth

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Fig. 1.

Overview of ion channels remodeling contributing to the action potential alteration of the atrial myocytes in diabetes mellitus. In diabetes mellitus, I ${}_{\text{Na}}$ , I ${}_{\text{Na-L}}$ , I ${}_{\text{Ca}}$ , I ${}_{\text{to}}$ , I ${}_{\text{Kur}}$ , SK, NCX in atrium myocytes are altered, resulting in prolonged action potential duration and reduced atrial conduction velocity, increased incidence of atrial fibrillation. I ${}_{\text{Na}}$ , the voltage-gated sodium channel current; I ${}_{\text{Na-L}}$ , the late sodium current; I ${}_{\text{Ca}}$ , the voltage gated calcium current; I ${}_{\text{to}}$ , the transient outward potassium currents; I ${}_{\text{Kur}}$ , the ultra-rapid delayed rectifier potassium current; SK, that small conductance calcium-activated potassium channels; NCX, the Na ${}^{+}$ -Ca ${}^{2+}$ exchanger current.

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Rev. Cardiovasc. Med. Print ISSN 1530-6550 Electronic ISSN 2153-8174