The link between diabetes and atrial fibrillation: cause or correlation?

Atrial fibrillation (AF) is the most common form of arrhythmia in the world. As the population ages, it is estimated that the prevalence of AF will increase by 2.5 fold in the next 50 years.1 At the same time, diabetes has become a pandemic disease in the western world as well as in developing countries. Independent risk factors for chronic AF include hypertension, heart failure, valvular heart disease and cardiomyopathy. The development of AF is likely to be multifactorial and the mechanism is elusive, while there is emerging evidence on the correlation between AF and diabetes mellitus (DM). DM and AF share common antecedents such as hypertension, atherosclerosis and obesity. Population-based studies suggested that DM is an independent risk factor for atrial fibrillation.2 Both DM and AF are marked predictor for stroke and mortality. The causal relation between DM and AF is still debatable and will be discussed.