DOI: 10.1161/jaha.123.031269 ISSN: 2047-9980

Impact of Sodium‐Glucose Cotransporter 2 Inhibitor on Recurrence After Catheter Ablation for Atrial Fibrillation in Patients With Diabetes: A Propensity‐Score Matching Study and Meta‐Analysis

Zixu Zhao, Chao Jiang, Liu He, Shiyue Zheng, Yufeng Wang, Mingyang Gao, Yiwei Lai, Jingrui Zhang, Mingxiao Li, Wenli Dai, Song Zuo, Xueyuan Guo, Songnan Li, Chenxi Jiang, Nian Liu, Ribo Tang, Deyong Long, Xin Du, Caihua Sang, Jianzeng Dong, Changsheng Ma
  • Cardiology and Cardiovascular Medicine
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Background

The association between sodium‐glucose cotransporter 2 inhibitors (SGLT2i) and atrial fibrillation (AF) recurrence after catheter ablation among patients with diabetes and AF remains unclear.

Methods and Results

Patients with AF undergoing initial catheter ablation with a history of diabetes from the China AF registry were included. Patients using SGLT2i were identified and matched by propensity score with non‐SGLT2i patients in a 1:3 ratio. The main outcome was AF recurrence during the 18‐month follow‐up. A total of 138 patients with diabetes with SGLT2i therapy and 387 without SGLT2i were analyzed. AF recurrence occurred in 37 patients (26.8%) in the SGLT2i group and 152 patients (39.3%) in the non‐SGLT2i group during a total of 593.3 person‐years follow‐up. The SGLT2i group was associated with lower AF recurrence compared with the non‐SGLT2i group (hazard ratio, 0.63 [95% CI, 0.44–0.90], P =0.007). A total of 4 studies were analyzed in our meta‐analysis demonstrating that SGLT2i was associated with lower AF recurrence after catheter ablation (odds ratio, 0.61 [95% CI, 0.54–0.69]; P <0.001, I 2 =0.0%).

Conclusions

Our prospective study coupled with a meta‐analysis demonstrated a lower risk of AF recurrence with the use of SGLT2i among patients with diabetes after AF ablation.

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