CONGRESS ABSTRACT

Background: Recent studies have suggested a potential antiarrhythmic role for Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in patients with atrial tachyarrhythmias. However, their effects on reducing the recurrence of atrial fibrillation (AF) following catheter ablation (CA) have not been thoroughly investigated. Objective: This study aimed to determine whether SGLT2i can reduce the risk of AF recurrence after AF CA. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched Medline and Scopus to identify all observational studies published up to October 2024 that assessed the risk of AF recurrence in patients treated with or without SGLT2i after AF CA. The risk of AF was evaluated using the Mantel-Haenszel random effects model, with odd ratio as the effect measure with relative 95% confidence intervals (CIs). Heterogeneity was assessed using the Higgins I² statistic, while a multivariable meta-regression analysis was used to analyse heterogeneity. Results: Our search strategy identified 5,456 patients with a history of AF who underwent CA. Among them, 2,514 received SGLT2i. A random effects model revealed that patients treated with SGLT2i had a significantly lower risk of AF recurrence (OR: 0.44; 95% CI, 0.29-0.67; I² = 65%) compared to those not receiving treatment during the same follow-up period (Figure 1). A multivariable meta-regression analysis, which included age, male sex, and a history of hypertension, explained a significant portion of the heterogeneity (R² = 58.2%; p = 0.01). Conclusion: The administration of SGLT2i following AF CA significantly reduces the risk of AF recurrence, highlighting the pleiotropic effects of this class of drugs.