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
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.