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The causal relationship between type 1 diabetes mellitus (T1D) and AF is poorly defined. T1D and AF share many underlying risk factors, but how T1D may promote AF independently of obesity and other features typical of T2D is not known. Here, we critically review the quality of the available clinical evidence specifically linking AF with the distinct characteristics of T1D and evaluate the mechanistic insights from preclinical models. We provide a conceptual overview of candidate contributing players and highlight important gaps in knowledge, unmet clinical needs, and potential therapeutic perspectives.<\/jats:p>","DOI":"10.1093\/cvr\/cvaf252","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T18:36:18Z","timestamp":1764182178000},"page":"2644-2667","source":"Crossref","is-referenced-by-count":2,"title":["Type 1 diabetes mellitus and atrial fibrillation: clinical relationships, mechanistic insights, and therapeutic implications"],"prefix":"10.1093","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9800-850X","authenticated-orcid":false,"given":"Florian","family":"Bruns","sequence":"first","affiliation":[{"name":"Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen , Hufelandstr. 55, Essen 45122 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3965-6165","authenticated-orcid":false,"given":"Anke C","family":"Fender","sequence":"additional","affiliation":[{"name":"Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen , Hufelandstr. 55, Essen 45122 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9741-9112","authenticated-orcid":false,"given":"Theresa","family":"Poppenborg","sequence":"additional","affiliation":[{"name":"Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen , Hufelandstr. 55, Essen 45122 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5843-5961","authenticated-orcid":false,"suffix":"Jr.","given":"Samuel C","family":"Dudley","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, The Lillehei Heart Institute, University of Minnesota , Minneapolis, MN 55455 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4612-117X","authenticated-orcid":false,"given":"Dobromir","family":"Dobrev","sequence":"additional","affiliation":[{"name":"Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen , Hufelandstr. 55, Essen 45122 ,","place":["Germany"]},{"name":"Department of Medicine and Research Center, Montreal Heart Institute and Universit\u00e9 de Montr\u00e9al , Montr\u00e9al, QC, H1T 1C8 ,","place":["Canada"]},{"name":"Department of Integrative Physiology, Baylor College of Medicine , Houston, TX 77030 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