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Impact of SGLT2 Inhibitors on AF Recurrence After Catheter Ablation in Patients With Type 2 Diabetes

Moh'd Rasheed Abu-Qaoud1, Ashish Kumar2, Tushar Tarun3

  • 1Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, Massachusetts, USA.

JACC. Clinical Electrophysiology
|August 11, 2023
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) significantly reduce atrial fibrillation (AF) recurrence after catheter ablation in type 2 diabetes patients. This leads to fewer cardioversions, antiarrhythmic drug therapies, and repeat ablations.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • The impact of sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) on recurrent atrial fibrillation (AF) post-catheter ablation is not well-established.
  • Atrial fibrillation is a common arrhythmia, and catheter ablation is a primary treatment modality.

Purpose of the Study:

  • To evaluate the effectiveness of SGLT2-Is in preventing AF recurrence after catheter ablation.
  • To assess the impact of SGLT2-Is on key clinical outcomes in patients with type 2 diabetes mellitus (DM).

Main Methods:

  • Retrospective analysis of patients with type 2 DM who underwent AF ablation using the TriNetX research network (April 2014 - November 2021).
  • Patients were stratified by baseline SGLT2-I use and propensity-score matched (2,225 per group).
  • Primary outcome: composite of cardioversion, new antiarrhythmic drug (AAD) therapy, or re-do AF ablation. Secondary outcomes included heart failure, stroke, hospitalization, and death.

Main Results:

  • SGLT2-I use was associated with a significantly lower risk of AF recurrence (composite outcome: OR 0.68, P < 0.0001).
  • Patients on SGLT2-Is demonstrated higher event-free survival at 12 months (HR 0.85, P = 0.003).
  • Secondary outcomes, except ischemic stroke, were also lower in the SGLT2-I group.

Conclusions:

  • SGLT2-Is are associated with a reduced risk of arrhythmia recurrence following AF ablation in patients with type 2 DM.
  • This suggests SGLT2-Is may play a beneficial role in managing AF post-ablation, reducing the need for further interventions.
Keywords:
SGLT2 inhibitorsatrial fibrillationcatheter ablation

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