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Updated: Jun 3, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Impact of Sodium-Glucose Co-Transporter 2 Inhibitors on Atrial Fibrillation Recurrence Post-Catheter Ablation Among

Naser A Abdelhadi1, Khaled Mohamed Ragab2, Mohammed Elkholy3

  • 1Division of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, Virginia, USA.

Journal of Cardiovascular Electrophysiology
|January 10, 2025
PubMed

Insights

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) significantly reduce atrial fibrillation recurrence after catheter ablation in diabetic patients. SGLT2i use also lowers hospitalization and stroke risk, though mortality benefits were not observed.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Atrial fibrillation (AF) is a primary cause of cardiomyopathy.
  • Effective AF management includes medical therapy, catheter ablation (CA), and goal-directed therapy.
  • Sodium-glucose co-transporter 2 inhibitors (SGLT2i) show cardiovascular benefits in heart failure patients.

Purpose of the Study:

  • To evaluate SGLT2 inhibitors' effect on preventing AF recurrence post-catheter ablation.
  • To assess SGLT2i impact on other cardiovascular outcomes in AF patients undergoing CA.

Main Methods:

  • A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane databases.
  • Eligible studies published up to April 10, 2024, were included.
  • Nine studies involving 16,857 patients were analyzed.

Main Results:

  • SGLT2 inhibitors significantly reduced AF recurrence after CA compared to non-SGLT2i medications (RR=0.72, p<0.00001).
  • SGLT2i therapy was linked to decreased all-cause hospitalizations and reduced ischemic stroke risk.
  • No significant difference in all-cause mortality was found between the groups.

Conclusions:

  • SGLT2 inhibitors demonstrate efficacy in reducing AF recurrence post-catheter ablation, particularly in diabetic patients.
  • SGLT2i use is associated with improved cardiovascular outcomes, including lower hospitalization and stroke risk.
  • While not impacting mortality, SGLT2i's reduction in hospitalizations suggests a favorable cardiovascular profile.
Keywords:
atrial fibrillationcatheter ablationsodium‐glucose co‐transporter 2 inhibitorstype 2 diabetes mellitus

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