Liu Hao-Tien, Wo Hung-Ta, Chang Po-Cheng, Lee Hui-Ling, Wen Ming-Shien, Chou Chung-Chuan
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Branch, 33305 Taoyuan, Taiwan.
School of Medicine, Chang Gung University College of Medicine, 33302 Taoyuan, Taiwan.
Heliyon. 2023 Jun 1;9(6):e16835. doi: 10.1016/j.heliyon.2023.e16835. eCollection 2023 Jun.
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce new-onset atrial fibrillation (AF) in patients with type 2 diabetes mellitus (T2DM). We aimed to determine the long-term effects of SGLT2i on atrial tachyarrhythmia recurrence after catheter ablation (CA) in T2DM patients.
This retrospective study enrolled consecutive patients with T2DM undergoing CA for AF between January 2016 and December 2021. Patient baseline demographic characteristics and use of anti-diabetic and anti-arrhythmic medications were analyzed. Echocardiographic parameters were obtained one day and 6 months after CA.
Our study population comprised 122 patients (70% paroxysmal AF). The baseline patient characteristics were similar between the SGLT2i-treated group (n = 45) and the non-SGLT2i-treated group (n = 77) except for stroke. At 6-month follow-up, body-mass index (BMI) was significantly decreased and left ventricular ejection fraction (LVEF) was significantly increased only in the SGLT2i group. E/e' was decreased 6 months after CA in both groups. During a mean follow-up of 33.7 ± 21.6 months, 22 of 122 patients had atrial tachyarrhythmia recurrence. The long-term atrial tachyarrhythmia-free survival rate was significantly higher in the SGLT2i-treated patients, and multivariate analysis revealed that AF type and SGLT2i use were independently associated with atrial tachyarrhythmia recurrence after CA.
The use of SGLT2i and AF type were independent risk factors associated with atrial tachyarrhythmia recurrence after CA in T2DM patients with AF. This result was at least partly due to the pleiotropic effects of SGLT2i on BMI reduction and left ventricular function improvement.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）可降低2型糖尿病（T2DM）患者新发心房颤动（AF）的风险。我们旨在确定SGLT2i对T2DM患者导管消融（CA）后房性快速性心律失常复发的长期影响。
这项回顾性研究纳入了2016年1月至2021年12月期间连续接受CA治疗AF的T2DM患者。分析了患者的基线人口统计学特征以及抗糖尿病和抗心律失常药物的使用情况。在CA后1天和6个月获得超声心动图参数。
我们的研究人群包括122例患者（70%为阵发性AF）。除中风外，SGLT2i治疗组（n = 45）和非SGLT2i治疗组（n = 77）的患者基线特征相似。在6个月的随访中，仅SGLT2i组的体重指数（BMI）显著降低，左心室射血分数（LVEF）显著升高。两组在CA后6个月时E/e'均降低。在平均33.7±21.6个月的随访期间，122例患者中有22例出现房性快速性心律失常复发。SGLT2i治疗的患者长期无房性快速性心律失常生存率显著更高，多因素分析显示AF类型和SGLT2i的使用与CA后房性快速性心律失常复发独立相关。
在AF的T2DM患者中，SGLT2i的使用和AF类型是与CA后房性快速性心律失常复发相关的独立危险因素。这一结果至少部分归因于SGLT2i对降低BMI和改善左心室功能的多效性作用。
