Int J Arrhythm.  2022 Mar;23(1):6. 10.1186/s42444-021-00057-5.

Pathophysiological aspects of insulin resistance in Atrial Fibrillation: novel therapeutic approaches

  • 1Lahore College for Women University, Near Wapda Flats Jail Rd, Jubilee Town, Lahore 54000, Punjab, Pakistan
  • 2Forman Christian College (A Chartered University), Zahoor Elahi Rd, Gulberg III, Lahore, Punjab 54600, Pakistan


Insulin resistance is associated with metabolic disorders including diabetes, obesity, hypertension, and inflammation which are the risk factors for Atrial Fibrillation. Many studies have reported that type 2 diabetes and AF are related and also their prevalence is increasing globally. Moreover, insulin resistance begins the type 2 diabetes. Main body: This review explains the pathophysiological aspects of insulin resistance in AF patients and discusses the drugs that are used to manage insulin resistance including Biguanides (metformin), thiazolidinediones (TZDs) [Pioglitazone, rosiglitazone], Sodium-glucose cotransporter 2 (SGLT2) inhibitors, Concentrated Insulin Products, Dipeptidyl peptidase-4 (DPP-4) Inhibitors, Glucagon-like peptide 1 (GLP-1) receptor Agonists, Pramlintide, Sulfonylureas, Meglitinides, α-Glucosidase Inhibitors, Colesevelam, Bromocriptine. This review will highlight a few major drugs that played a significant role in AF patients. For this purpose, many databases were used for reviewing the literature and keywords are used such as Insulin Resistance, Pathophysiology, Atrial Fibrillation, and Drugs.
This review article concludes that insulin resistance is related to AF. It also provides an outlook on the recent pathophysiological aspects of insulin resistance in AF; however, more studies are needed to clarify the management of insulin resistance in AF patients to prevent the development of type 2 diabetes.


Insulin resistance; Pathophysiology; Atrial Fibrillation; Drugs
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