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Association of SGLT2 Inhibitor Use with All-Cause Mortality Following CIED Implantation for Conduction Disease in

Hidayet Ozan Arabaci1, Fatih Ozkan2, Zafer Guven2

  • 1Department of Cardiology, Yuksekova State Hospital, 30300 Hakkari, Turkey.

Journal of Clinical Medicine
|July 28, 2026
PubMed

Insights

Sodium-glucose cotransporter-2 (SGLT2) inhibitor use was linked to reduced mortality in patients receiving cardiac implantable electronic devices (CIEDs) for conduction disease. This suggests SGLT2 inhibitors may improve survival in this specific patient group.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Patients with cardiac implantable electronic devices (CIEDs) for conduction disease face long-term mortality risks, even with preserved systolic function.
  • The impact of sodium-glucose cotransporter-2 (SGLT2) inhibitors on mortality in this population is not well understood.

Purpose of the Study:

  • To investigate the association between early SGLT2 inhibitor use and all-cause mortality in patients with preserved left ventricular ejection fraction (LVEF) undergoing CIED implantation for conduction disease.

Main Methods:

  • Retrospective cohort study of 540 patients with LVEF ≥ 50% undergoing CIED implantation for conduction disease.
  • SGLT2 inhibitor exposure defined as use within 3 months post-implantation.
  • All-cause mortality assessed using multivariable Cox regression and Kaplan-Meier analysis over a median follow-up of 64.2 months.

Main Results:

  • 206 patients (38.1%) had documented SGLT2 inhibitor exposure.
  • SGLT2 inhibitor use was associated with a significantly lower adjusted hazard of death (HR, 0.48; p < 0.001).
  • Improved survival observed in SGLT2 inhibitor users in the overall cohort and in subgroups without heart failure or diabetes.

Conclusions:

  • Early SGLT2 inhibitor use is independently associated with reduced all-cause mortality in patients with preserved LVEF receiving CIEDs for conduction disease.
  • These findings are hypothesis-generating and highlight the potential benefit of SGLT2 inhibitors in this population.
  • Prospective studies are warranted to confirm these observational results.

Keywords:
all-cause mortalitybradyarrhythmiacardiac conduction diseasecardiac implantable electronic devicespreserved left ventricular ejection fractionsodium–glucose cotransporter-2 inhibitors

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