Basile Paolo, Monitillo Francesco, Santoro Daniela, Falco Giorgia, Carella Maria Cristina, Khan Yamna, Moretti Arcangelo, Santobuono Vincenzo Ezio, Memeo Riccardo, Pontone Gianluca, Forleo Cinzia, Ciccone Marco Matteo, Guaricci Andrea Igoren
Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Polyclinic University Hospital, Bari, Italy.
Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
J Cardiol. 2025 Mar;85(3):229-234. doi: 10.1016/j.jjcc.2024.09.005. Epub 2024 Sep 13.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have revolutionized the therapeutic scenario of heart failure, demonstrating favorable effects on mortality and quality of life. Previous studies have yielded conflicting data regarding the effects on ventricular arrhythmias.
A prospective observational study was conducted to investigate the anti-arrhythmic properties of SGLT2 inhibitors evaluating the intra-patient difference in major adverse arrhythmic cardiac events (MAACE) over a six-month period in patients with chronic heart failure who were undergoing continuous monitoring using a cardiac implantable electronic device.
From January 2022 to January 2023, 82 patients [median age 63 years (IQR 15), male 87 %] were enrolled in the study, with a median follow-up of 28 weeks (IQR 5). The rate of MAACE at baseline was 11 %, without relevant differences in the follow up in terms of major and minor arrhythmic events. In patients with an arrhythmic phenotype at baseline, a mild but non statistically significant reduction of MAACE (from 36 % to 28 %, p = 0.727) was observed and a significant decrease of non-sustained ventricular tachycardia (from 68 % to 32 %, p = 0.022).
Our findings suggest potential anti-arrhythmic properties of SGLT2 inhibitors, evident in patients with arrhythmic events before the initiation of the drug.
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂彻底改变了心力衰竭的治疗局面，对死亡率和生活质量显示出有益影响。先前的研究关于其对室性心律失常的影响产生了相互矛盾的数据。
进行了一项前瞻性观察性研究，以调查SGLT2抑制剂的抗心律失常特性，评估使用心脏植入式电子设备进行持续监测的慢性心力衰竭患者在六个月期间主要不良心律失常心脏事件（MAACE）的患者内差异。
从2022年1月至2023年1月，82例患者[中位年龄63岁（四分位间距15），男性87%]纳入研究，中位随访28周（四分位间距5）。基线时MAACE发生率为11%，在主要和次要心律失常事件的随访方面无相关差异。在基线时有心律失常表型的患者中，观察到MAACE有轻度但无统计学意义的降低（从36%降至28%，p = 0.727），非持续性室性心动过速有显著降低（从68%降至32%，p = 0.022）。
我们的研究结果表明SGLT2抑制剂具有潜在的抗心律失常特性，在开始用药前有心律失常事件的患者中表现明显。
