Effects of Combined Therapy with SGLT2i and GLP-1RAs on Atrial Fibrillation Recurrence After Catheter Ablation in...

Area of Science:

• Cardiology
• Endocrinology
• Pharmacology

Background:

• Atrial fibrillation (AF) is a common complication in type 2 diabetes mellitus (T2DM).
• Catheter ablation is a treatment for AF, but recurrence remains a challenge, particularly in T2DM patients.
• Current diabetes therapies may influence AF recurrence post-ablation.

Purpose of the Study:

• To investigate the impact of sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RAs), and their combination on AF recurrence after catheter ablation in T2DM patients.
• To assess the effect of these antidiabetic agents on inflammatory and oxidative stress markers post-ablation.

Main Methods:

• Prospective cohort study involving T2DM patients undergoing AF ablation.
• Patients were categorized into three groups: SGLT2i users, GLP-1RA users, and combined SGLT2i/GLP-1RA users.
• AF recurrence was monitored for 12 months using implantable continuous monitoring (ICM); inflammatory/oxidative stress markers were also assessed.

Main Results:

• Patients on combined SGLT2i/GLP-1RA therapy exhibited significantly lower AF recurrence rates compared to monotherapy groups (p < 0.05).
• Combined therapy was associated with reduced serum inflammatory and oxidative stress markers at 12 months.
• Despite higher HbA1c levels (>7%), the combination therapy demonstrated these benefits.

Conclusions:

• Combined SGLT2i and GLP-1RA therapy is effective in reducing AF recurrence post-catheter ablation in T2DM patients.
• This combination therapy also mitigates inflammation and oxidative stress, independent of glycemic control.
• These findings suggest a potential synergistic benefit of combined SGLT2i/GLP-1RA use in managing AF in T2DM.