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The following is a summary of “Impact of sodium-glucose cotransporter 2 inhibitors on catheter ablation for atrial fibrillation in heart failure patients without type-2 diabetes,” published in the January 2025 issue of Cardiology by Harada et al.
Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have shown a potential to reduce new-onset atrial arrhythmias in people with type-2 diabetes (T2DM) or heart failure (HF). Their impact on people with HF but without T2DM undergoing catheter ablation for atrial fibrillation (AF) remains unclear.
Researchers conducted a prospective study to evaluate the effect of SGLT2 is on catheter ablation outcomes for AF in people with HF but without T2DM.
They enrolled 102 people with persistent AF (PeAF) and HF (N-terminal prohormone of brain natriuretic peptide [NT-proBNP] ≥400 pg/ml), excluding people with T2DM, 51 people (SGLT2i[+]) received SGLT2is for at least 1 month before the procedure and continued during follow-up. In comparison, 51 people (SGLT2i[−]) did not. Left atrial pressure (LAP) was measured before the procedure, and the event-free rate of early and 1-year atrial arrhythmia recurrence was compared.
The results showed no difference in baseline characteristics between the 2 groups. People in the SGLT2i[+] group had a significant reduction in average LAP (9.3 ± 4.8 mmHg vs. 12.1 ± 6.6 mmHg, P<0.01) and normalized LAP to systemic blood pressure (0.11 ± 0.05 vs. 0.15 ± 0.07, P<0.01). Serum NT-proBNP levels were similar at enrollment but were lower in the SGLT2i[+] group on the day of the procedure (P=0.06) and 1 month after (P<0.01). The SGLT2i[+] group had a higher event-free rate for early (92% vs. 60%, P<0.01) and 1-year (89% vs. 75%, P<0.05) atrial arrhythmia recurrence.
They concluded that periprocedural treatment with SGLT2is reduced LAP and improved the outcomes of catheter ablation for PeAF in people with HF but without T2DM.
Source: internationaljournalofcardiology.com/article/S0167-5273(24)01576-6/abstract
