Autonomic dysfunction is associated with brief episodes of atrial fibrillation in type 2 diabetes

Maria Rosaria Rizzo, Ferdinando Carlo Sasso, Raffaele Marfella*, Mario Siniscalchi, Pasquale Paolisso, Ornella Carbonara, Maria Carmela Capoluongo, Nadia Lascar, Caterina Pace, Celestino Sardu, Beatrice Passavanti, Michelangela Barbieri, Ciro Mauro, Giuseppe Paolisso

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Methods and Results In a multicentric cross-sectional controlled study, 1992 patients with type 2 diabetes were screened. All underwent ambulatory ECG recording for 48-hour at 3, 6, 9, and 12 months. Heart rate variability (HRV) was used as indicator of autonomic activity. One hundred seventy-six diabetics with silent atrial fibrillation episodes (SAFE group) and 288 without silent atrial fibrillation (non-SAFE group) were enrolled. These selected diabetics were matched on clinical and anthropometric data to 120 control subjects without diabetes of the control group. HRV analysis evidenced that LF/HF ratio was significantly higher in the SAFE group than in the non-SAFE group (P < 0.05) in the whole period of HM analysis. AF absolute burdens were positively correlated with LF/HF ratio (r = 0.31, P < 0.001). Multiple regression analysis showed that LF/HF ratio was an independent determinant of AF episodes.

Conclusions This study originally showed a strong relationship between autonomic dysfunction and silent atrial fibrillation in type 2 diabetes.

Background and Aims This study aimed to investigate the relationship between asymptomatic episodes of atrial fibrillation (AF) and abnormalities of the autonomic nervous system in type 2 diabetic patients who did not have evidence of atrial fibrillation at baseline.

Original languageEnglish
Pages (from-to)88-92
Number of pages5
JournalJournal of Diabetes and its Complications
Issue number1
Publication statusPublished - 1 Jan 2015

Bibliographical note



  • Atrial fibrillation
  • Autonomic nervous system
  • ECG Holter
  • Heart rate variability
  • Type 2 diabetes


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