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[Atrial fibrillation in patients with type 2 diabetes mellitus: specific features of development and antirecurrence therapy].

We examined 212 patients aged 52-70 years with persistent symptomatic atrial fibrillation (AF). Comparison of AF substrates in patients with (n=26) and without (n=27) type 2 diabetes mellitus (DM2) revealed slowing of intraatrial conduction, increased vulnerability of atria, and more pronounced worsening of left ventricular diastolic function among DM2 patients. Comparison of groups of patients with (n=32) and without (n=33) diabetic cardiac autonomic neuropathy (CAN) revealed augmentation of adrenergic influences on the heart and comparatively higher antirecurrence efficacy of sotalol among patients with CAN. In 94 patients with type 2 DM complicated with CAN after randomization we administered antiarrhythmic therapy with sotalol in combination with perindopril (n=33), lipoic acid (n=31), perindopril and lipoic acid (n=30), and compared results with sotalol monotherapy. In 6 months percentage of patients in sinus rhythm was significantly higher in the group of combination therapy (sotalol plus perindopril plus lipoic acid). This was probably a result of simultaneous correction of disturbances caused by both "diabetic cardiomyopathy" and CAN.