Glucose metabolic dysregulation of diabetes and Its role in atrial fibrillation pathogenesis

Atrial fibrillation (AF) is the most prevalent persistent arrhythmia in clinical practice, with a complex pathogenesis that remains incompletely understood. Emerging evidence underscores a strong association between diabetes and the occurrence of AF, highlighting a significantly elevated risk among diabetic patients. This increased susceptibility is not solely attributable to chronic hyperglycemia but is also shaped by blood glucose fluctuations and dysregulated glucose metabolism. In this review, we summarize the mechanisms by which hyperglycemia and blood glycemic variability contribute to the onset of AF, and the potential involvement of abnormal glucose metabolism pathways and metabolic disturbances induced by diabetes in the pathogenesis of AF.