[Features of atrial fibrillation pharmacotherapy in patients with diabetes mellitus.].

The article analyzes the data of the modern literature on the incidence of atrial fibrillation in patients with diabetes mellitus, the significance of the presence of diabetes mellitus in patients as a risk factor for the development of atrial fibrillation, as well as appropriate hypoglycemic therapy. The results of the studies confirm that diabetes mellitus increases the risk of cardiovascular diseases, including atrial fibrillation, which significantly worsens the quality of life and increases mortality. The main mechanism of the relationship between diabetes and atrial fibrillation is myocardial fibrosis caused by hyperglycemia and oxidative stress. This leads to diastolic dysfunction of the heart and electrical remodeling, which increases the risk of arrhythmias and cardiovascular events. Hypoglycemic agents such as metformin and sodium-glucose co-transporter 2 inhibitors can reduce the risk of atrial fibrillation. At the same time, insulin can increase the risk of atrial fibrillation, which emphasizes the importance of choosing therapeutic strategies for the prevention of arrhythmias. The duration of diabetes also affects the risk of stroke, especially in patients with insulin-dependent diabetes. Oral anticoagulants are recommended for patients with diabetes and a high CHA2DS2-VASc score, but the need for therapy in patients with a low score remains controversial. Patients with diabetes, among other things, have an increased risk of early recurrence of atrial fibrillation after cardioversion. In addition, studies show that anti-arrhythmia agents may be less effective in patients with diabetes. In contrast, catheter ablation has shown high efficacy in these patients. Thus, these results highlight the need to take into account the condition of patients with diabetes when planning standard therapy for atrial fibrillation in order to improve its effectiveness.