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Impact of Sodium-glucose co-transporter 2 inhibitors on Atrial Fibrillation Recurrence Post- catheter ablation among patients with type 2 diabetes mellitus: A systematic review and meta-analysis
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  • Naser A. Abdelhadi,
  • Khaled Mohamed Ragab,
  • Mohammed Elkholy,
  • Jayanthi Koneru,
  • Kenneth Ellenbogen,
  • Ajay Pillai
Naser A. Abdelhadi
Virginia Commonwealth University

Corresponding Author:naser.abdelhadi@vcuhealth.org

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Khaled Mohamed Ragab
Minia University Faculty of Medicine
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Mohammed Elkholy
Beth Israel Deaconess Medical Center Harvard University
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Jayanthi Koneru
Virginia Commonwealth University
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Kenneth Ellenbogen
Virginia Commonwealth University
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Ajay Pillai
Virginia Commonwealth University
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Abstract

Background Atrial fibrillation (AF) is the most common cause of arrhythmia-induced cardiomyopathy. Effective management strategies include medical therapy for rate and rhythm control, catheter ablation (CA), and goal directed medical therapy. Sodium-glucose co-transporter 2 inhibitors (SGLT2i), a novel class of anti-diabetic drugs, have shown a promising impact in reducing cardiovascular events in diabetic and non-diabetic heart failure (HF) patients. It is unclear what impact SGLT2i use may have on AF recurrence following catheter ablation. Aim To evaluate the effects of SGLT2i on preventing AF recurrence following CA and impact on other cardiovascular outcomes. Methods and results We performed a comprehensive literature search through multiple search engines (Pubmed, Scopus, Web of Science, and Cochrane) to include eligible studies using the appropriate keywords until 10th April 2024. Our search yielded nine eligible studies with 16,857 patients. Our analysis reveals a significant reduction in AF recurrence after catheter ablation among patients receiving SGLT2i compared to non-SGLT2i medications (RR = 0.72, 95% CI [0.67, 0.78], P < 0.00001). Additionally, SGLT2i therapy was associated with decreased all-cause hospitalizations and reduced risk of ischemic stroke. However, no significant difference in all-cause mortality was observed between SGLT2i and non-SGLT2i groups. Conclusion Our study found that SGLT2 inhibitors significantly reduced AF recurrence post-CA in diabetic patients. Moreover, SGLT2i use was associated with lowered hospitalization and ischemic stroke risk. Though no significant difference in mortality was noted, the decrease in hospitalization suggests a possible favorable effect on cardiovascular events.
02 Aug 2024Submitted to Journal of Cardiovascular Electrophysiology
05 Aug 2024Submission Checks Completed
05 Aug 2024Assigned to Editor
05 Aug 2024Review(s) Completed, Editorial Evaluation Pending
06 Aug 2024Reviewer(s) Assigned
29 Sep 2024Editorial Decision: Revise Minor
10 Nov 20241st Revision Received