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Article Abstract
Aims: The impact of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on atrial fibrillation (AF) recurrence after catheter ablation is still inconclusive. Besides, their efficacy on AF recurrence stratified by metabolic syndrome (MetS) status remains unknown.
Methods: Patients with AF undergoing initial catheter ablation between January 2017 and December 2023 from the China-AF Registry were included. Patients were 1:1 propensity score-matched by SGLT2i use at discharge and stratified by baseline MetS status. The main outcome was the AF recurrence after a 3-month blanking period.
Results: After propensity score matching, 573 patients in the SGLT2i group and 573 in the non-SGLT2i group were included in the study. During the 20.5 ± 13.7 months follow-ups, AF recurrence occurred in 100 patients (17.5%) in the SGLT2i group and 168 patients (29.3%) in the non-SGLT2i group. SGLT2i was associated with lower AF recurrence (17.5% vs. 29.3%; HR 0.59, 95% CI: 0.46-0.75, p < 0.001), with consistent benefits in MetS (HR 0.61, 95% CI: 0.39-0.75, p = 0.03) and non-MetS subgroups (HR 0.58, 95% CI: 0.43-0.78, p < 0.001, P = 0.841). The effect of SGLT2i on the AF recurrence also remained consistent across the body mass index (BMI) spectrum (P = 0.740).
Conclusion: SGLT2i was associated with a lower risk of AF recurrence after catheter ablation independently of MetS status or BMI spectrum.
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