Abstract 4145690: Impact of Sodium-Glucose Cotransporter 2 Inhibitors on Atrial Fibrillation Recurrence After Catheter Ablation in Patients with Diabetes: A Systematic Review and Meta-Analysis

Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiovascular benefits beyond glycemic control, including potential anti-arrhythmic effects. The impact of SGLT2 inhibitors on atrial fibrillation (AF) recurrence following catheter ablation in diabetic patients is an area of emerging interest. The purpose of this meta-analysis was to evaluate the impact of SGLT2 inhibitors on AF recurrence following catheter ablation in patients with diabetes. Methods: A comprehensive literature search was carried out using PubMed, Embase, and Google Scholar databases for the studies comparing SGLT2 inhibitors with other antidiabetic drugs in AF patients undergoing catheter ablation. Using random effect models, Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size. Statistical significance was set at p < 0.05. Egger's regression test and Begg-Mazumdar's rank test were used to assess publication bias. The primary endpoint was the reoccurrence of atrial fibrillation after catheter ablation during the follow-up period, which varied between studies and ranged from 12 to 33 months. Results: The analysis included six studies, involving a sample size of around 5,765 AF patients. Our study reported that the use of SGLT2 inhibitors in diabetic patients undergoing catheter ablation for AF was associated with lower odds of AF reoccurrence (OR: 0.46; 95% CI: 0.32 to 0.65; p<0.0001) compared with other antidiabetic medications. This outcome has moderately associated heterogeneity, with I2 of 59%. Egger's regression test and Begg-Mazumdar's rank test showed no evidence of publication bias (p > 0.05). Conclusion: The use of SGLT2 inhibitors was associated with improved outcomes post-catheter ablation for AF diabetic patients. Further large-scale, randomized controlled trials are warranted to confirm these findings and elucidate the underlying mechanisms.