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Review
. 2023 Aug 15;14(8):1163-1177.
doi: 10.4239/wjd.v14.i8.1163.

Dysglycemia and arrhythmias

Dong-Kun Sun  1 , Nan Zhang  1 , Ying Liu  1 , Jiu-Chun Qiu  1 , Gary Tse  1   2   3 , Guang-Ping Li  1 , Leonardo Roever  4 , Tong Liu  5
Affiliations
Review

Dysglycemia and arrhythmias

Dong-Kun Sun et al. World J Diabetes. .

Abstract

Disorders in glucose metabolism can be divided into three separate but interrelated domains, namely hyperglycemia, hypoglycemia, and glycemic variability. Intensive glycemic control in patients with diabetes might increase the risk of hypoglycemic incidents and glucose fluctuations. These three dysglycemic states occur not only amongst patients with diabetes, but are frequently present in other clinical settings, such as during critically ill. A growing body of evidence has focused on the relationships between these dysglycemic domains with cardiac arrhythmias, including supraventricular arrhythmias (primarily atrial fibrillation), ventricular arrhythmias (malignant ventricular arrhythmias and QT interval prolongation), and bradyarrhythmias (bradycardia and heart block). Different mechanisms by which these dysglycemic states might provoke cardiac arr-hythmias have been identified in experimental studies. A customized glycemic control strategy to minimize the risk of hyperglycemia, hypoglycemia and glucose variability is of the utmost importance in order to mitigate the risk of cardiac arrhythmias.

Keywords: Cardiac arrhythmia; Dysglycemia; Glucose variability; Hyperglycemia; Hypoglycemia.

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Conflict of interest statement

Conflict-of-interest statement: The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Graphic abstract. The association between dysglycemia and cardiac arrhythmias.
Figure 2
Figure 2
Mechanisms underlying the association between hyperglycemia and atrial fibrillation. APD: Action potential duration; APDD: Action potential duration dispersion; PNS: Parasympathetic nerve stimulation; SNS: Sympathetic nerve stimulation.
See this image and copyright information in PMC

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