Heart Rhythm O2最新文献

{"title":"Gender disparity in quality of life in patients with atrial fibrillation during the Syrian conflict: An observational cohort study","authors":"Ibrahim Antoun PhD ,&nbsp;Alkassem Alkhayer MSc ,&nbsp;Aref Jalal Eldin MD ,&nbsp;Alamer Alkhayer MD ,&nbsp;Khaled Yazji FRCP ,&nbsp;Riyaz Somani PhD ,&nbsp;G. André Ng PhD ,&nbsp;Mustafa Zakkar PhD","doi":"10.1016/j.hroo.2024.12.010","DOIUrl":"10.1016/j.hroo.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>The EuroQoL 5 dimensions is the first validated questionnaire to assess quality of life (QoL) in patients with atrial fibrillation (AF) in Syria.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the gender disparity in QoL in Syrian patients with AF during the ongoing conflict.</div></div><div><h3>Methods</h3><div>The study involved patients admitted to the emergency department of Tishreen University Hospital in Latakia, Syria, with AF as the primary diagnosis between June 2023 and June 2024. Arabic versions of the EuroQoL 5 dimensions were administered to patients on admission, and their demographic data were taken from their medical notes.</div></div><div><h3>Results</h3><div>A total of 406 satisfied the study criteria, of whom 180 (44%) were males; and the median age was 67 (57- 73) years. Compared with men, women had more congestive cardiac failure (CCF) (32% vs 22%; <em>P</em>=.001) and were more uneducated (48% vs 27%; <em>P</em>&lt;.001). Females demonstrated poorer QoL across all scoring dimensions (activities: 2.4 vs 1.7; mobility: 2.5 vs 1.6; self-care: 2.6 vs 1.8; pain: 2.6 vs 1.7; anxiety: 2.9 vs 1.8; EuroQol Visual Analogue Scale: 49.8 vs 79.8), all of which had <em>P</em>&lt;.001. Multivariable logistic regression demonstrated that women (odds ratio [OR]: 5.2; 95% confidence interval [CI] 2.2–7.6; <em>P</em>&lt;.001 and OR 6.2; 95% CI 3.1–9.7; <em>P</em>&lt;.001) and CCF (OR 3.3; 95% CI 1.5–6.9; <em>P</em>&lt;.001 and OR 4.2; 95% CI 2.2–7.3; <em>P</em>&lt;.001) were independently associated with poor QoL.</div></div><div><h3>Conclusion</h3><div>Syrian women admitted with AF had poorer QoL than did their men counterparts. CCF and female sex were independent predictors of poor QoL.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 3","pages":"Pages 362-367"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pacemaker implantation after surgical aortic valve replacement and balloon-expandable transcatheter aortic valve implantation: Incidence, predictors, and prognosis","authors":"Davide Gabbieri MD, PhD ,&nbsp;Italo Ghidoni MD ,&nbsp;Greta Mascheroni MD ,&nbsp;Matteo Chiarabelli RN, MSN ,&nbsp;Giuseppe D’Anniballe MD ,&nbsp;Paolo Pisi MD ,&nbsp;Marco Meli MD ,&nbsp;Clorinda Labia MD ,&nbsp;Alice Barbieri CP ,&nbsp;Francesca Spina CP ,&nbsp;Federico Giorgi MD","doi":"10.1016/j.hroo.2025.01.001","DOIUrl":"10.1016/j.hroo.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) remains a significant challenge despite new-generation devices.</div></div><div><h3>Objectives</h3><div>This study aimed to identify predictors of PPI during preoperative evaluation and assess its mid-term impact in a single-center, real-world setting.</div></div><div><h3>Methods</h3><div>From 2010 to 2020, 1486 patients with aortic stenosis underwent surgical aortic valve replacement or TAVI using balloon-expandable transcatheter heart valves. The PPI rate was estimated using the hospital discharge record for each patient in the Emilia-Romagna region.</div></div><div><h3>Results</h3><div>The 30-day incidence of PPI in the TAVI group was 3.4%. While 30-day PPI did not affect overall survival (log-rank, P = .494 NS), it predicted rehospitalization due to cardiac causes (hazard ratio 10.28; 95% confidence interval [CI] 95% 3.41–31.00; P &lt;.001). Calcifications in the leaflet (odds ratio [OR] 4.66; 95% CI 1.41–15.47; P = .012), left ventricular outflow tract (OR 4.51; 95% CI 1.48–13.76; P = .008), and device landing zone (OR 2.52; 9% CI 0.86–7.40; P = .093) were associated with a higher risk of PPI.</div></div><div><h3>Conclusion</h3><div>A low 30-day PPI incidence was observed, primarily because of the exclusive use of balloon-expandable SAPIEN transcatheter heart valves and high implantation techniques. Baseline factors such as leaflet, left ventricular outflow tract, and device landing zone calcifications, as well as right bundle branch block, highlight the need for comprehensive preoperative analysis to reduce PPI incidence and mitigate its associated longer hospital stays and rehospitalizations due to cardiac causes.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 3","pages":"Pages 259-272"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of systemic thromboembolism after transvenous lead implantation in patients with simple intracardiac shunts","authors":"Mitsutaka Nakashima MD, PhD ,&nbsp;Norihisa Toh MD, PhD ,&nbsp;Nobuhiro Nishii MD, PhD ,&nbsp;Teiji Akagi MD, PhD ,&nbsp;Kazufumi Nakamura MD, PhD ,&nbsp;Hiroshi Morita MD, PhD, FHRS ,&nbsp;Shinsuke Yuasa MD, PhD","doi":"10.1016/j.hroo.2024.12.007","DOIUrl":"10.1016/j.hroo.2024.12.007","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 3","pages":"Pages 390-392"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adoption of left bundle branch area pacing using stylet-driven lead in a tertiary academic training center: Learning curve and acute procedural outcomes","authors":"Suraya Hani Kamsani MBBS ,&nbsp;John L. Fitzgerald MBBS ,&nbsp;Anand Thiyagarajah MBBS, PhD ,&nbsp;Shaun Evans MBBS ,&nbsp;Mohanaraj Jayakumar MBBS ,&nbsp;Jonathan P. Ariyaratnam MB, Bchir, PhD ,&nbsp;Varun Malik MBBS, PhD ,&nbsp;Catherine O’Shea MBBS ,&nbsp;Bradley M. Pitman PhD ,&nbsp;Christopher X. Wong MBBS, PhD ,&nbsp;Mehrdad Emami MBBS, PhD ,&nbsp;Glenn D. Young MBBS, FHRS ,&nbsp;Dennis H. Lau MBBS, PhD, FHRS","doi":"10.1016/j.hroo.2024.12.009","DOIUrl":"10.1016/j.hroo.2024.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Left bundle branch area pacing (LBBAP) has recently emerged as a strategy for conduction system pacing.</div></div><div><h3>Objective</h3><div>The purpose of this study was to evaluate the initial learning experience and acute procedural success in adopting this procedure in an academic training center.</div></div><div><h3>Methods</h3><div>A retrospective review of LBBAP procedures using the Biotronik Solia stylet-driven lead from June 2022 to December 2023 was performed. Procedural and fluoroscopy times with electrocardiographic and pacing parameters were evaluated to determine safety and acute procedural outcomes.</div></div><div><h3>Results</h3><div>A total of 69 patients (mean age 75 ± 12 years; 60.9% male) underwent LBBAP implantation over 18 months for standard pacing indications by 10 implanters (including 7 fellows-in-training) without previous experience in LBBAP technique. Mean total procedural time was 74.1 ± 23.5 minutes, and mean fluoroscopy time for LBBAP lead insertion was 9.3 ± 5.4 minutes. Mean paced QRS duration was 115.2 ± 15.5 ms, and mean left ventricular activation time was 79.4 ± 14.5 ms. An rsRʹ pattern was achieved in 76.8%. LBBAP was successful in 78.3% (overall 43.5% single deployment; median 2 [interquartile range 1–3]) with excellent LBBAP lead parameters: threshold 0.8 ± 0.4 V at 0.4 ms; sensing 9.4 ± 4.2 mV; impedance 627 ± 131 Ω. Acute procedural complications included damaged lead helix requiring a second lead (4.3%), pneumothorax (2.9%), and acute LBBAP lead dislodgment (1.4%). Septal perforation occurred in 10.1% of cases with no acute sequelae. When analyzed in tertiles, the number of lead deployment attempts was significantly reduced with no changes to procedural success rates with increasing experience.</div></div><div><h3>Conclusion</h3><div>Adoption of LBBAP with stylet-driven lead in an academic training center is feasible and safe, with satisfactory success rates and no overly steep learning curve.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 3","pages":"Pages 253-258"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer Thanks","authors":"","doi":"10.1016/S2666-5018(25)00058-3","DOIUrl":"10.1016/S2666-5018(25)00058-3","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 3","pages":"Page 245"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrial remodeling and voltage-guided ablation outcome in persistent atrial fibrillation patients over 75 years of age","authors":"Halim Marzak MD ,&nbsp;Clément Baldacini MD ,&nbsp;François Severac MD ,&nbsp;Simon Fitouchi MD ,&nbsp;Thomas Cardi MD ,&nbsp;Mohamad Kanso MD ,&nbsp;Alexandre Schatz MD ,&nbsp;Patrick Ohlmann MD, PhD ,&nbsp;Olivier Morel MD, PhD ,&nbsp;Laurence Jesel MD, PhD","doi":"10.1016/j.hroo.2024.12.006","DOIUrl":"10.1016/j.hroo.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of atrial fibrillation (AF) increases with age. The improvement in ablation techniques has widened the indications, particularly in elderly patients. Data on LA remodeling and low-voltage zone (LVZ) extent in this subgroup are scarce.</div></div><div><h3>Objective</h3><div>We assessed the left atrial (LA) bipolar voltage, LVZ extent, and efficacy of voltage-guided ablation in a cohort of patients with persistent AF according to age.</div></div><div><h3>Methods</h3><div>Three hundred fifty-three patients with persistent AF undergoing a first voltage-guided ablation procedure were enrolled and divided into 2 groups: those &lt;75 years of age (n=286) and those ≥75 years of age (n=67). LA voltage maps were obtained in sinus rhythm. <em>LVZ</em> was defined as &lt;0.5 mV. A propensity score–matching analysis was used to assess the impact of age on LA remodeling.</div></div><div><h3>Results</h3><div>The LA bipolar voltage was lower (<em>P</em>&lt;.01) in elderly patients. LVZs were found in 67% of elderly patients and 30% of younger patients (<em>P</em>&lt;.01), especially in mild (<em>P</em>&lt;.01) and moderate (<em>P</em>&lt;.01) LVZs. After propensity score matching, these differences were no longer noticeable. Pulmonary vein isolation alone was performed in 33% of elderly patients and 70% of patients &lt;75 years of age (<em>P</em>&lt;.01). Female sex (<em>P</em>&lt;.001), age ≥ 75 years (<em>P</em>=.042), estimated glomerular filtration rate (<em>P</em>=.009), and LA volume index (<em>P</em>&lt;.001) were predictive of LVZ presence. After 36 months of follow-up, the AF-free survival rate after a single procedure was similar between the 2 groups.</div></div><div><h3>Conclusion</h3><div>Patients &gt;75 years of age with persistent AF display increased LA substrate remodeling than do younger patients. LA scar did not seem to negatively affect the results of substrate-guided ablation, and the complication rate was low.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 3","pages":"Pages 307-316"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracardiac electrogram analysis may allow for prediction of lesion transmurality after pulsed field ablation of atria in a porcine model","authors":"Jernej Štublar BSc ,&nbsp;Tomaž Jarm PhD ,&nbsp;Lars Mattison PhD ,&nbsp;Bryan D. Martin MSc ,&nbsp;Megan Schmidt PhD ,&nbsp;Matevž Jan MD, PhD ,&nbsp;Atul Verma MD ,&nbsp;Paul A. Iaizzo PhD ,&nbsp;Daniel C. Sigg MD, PhD ,&nbsp;Damijan Miklavčič PhD","doi":"10.1016/j.hroo.2024.11.025","DOIUrl":"10.1016/j.hroo.2024.11.025","url":null,"abstract":"<div><h3>Background</h3><div>Pulsed field ablation (PFA) is a novel cardiac ablation modality with an increasing clinical acceptance in treatment of atrial fibrillation due to its clinical efficacy and excellent safety profile. However, intraprocedural guidance for PFA to ensure durable pulmonary vein isolation (PVI) is lacking.</div></div><div><h3>Objective</h3><div>We quantified changes in intracardiac electrograms (iEGMs) following PFA and radiofrequency ablation (RFA) and investigated their applicability for prediction of lesion transmurality.</div></div><div><h3>Methods</h3><div>We induced 38 atrial lesions using PFA or RFA in 5 swine and monitored iEGMs continuously for up to 30 minutes postablation. The most characteristic changes in iEGMs were quantified after the decomposition using discrete wavelet transform, which allowed us to analyze the effects in separate frequency bandwidths.</div></div><div><h3>Results</h3><div>After the ablation, we observed a reduction of bipolar iEGM amplitude (for PFA and RFA) and an increase in unipolar iEGM amplitude (predominantly for PFA). These changes were due to 2 mechanisms with different frequency content. The low-frequency content of unipolar iEGMs (1–16 Hz) further enabled us to discriminate between transmural and nontransmural lesions in the case of PFA. The rate of reduction of initially increased current-of-injury effect reflected in the low-frequency content of unipolar iEGMs within the first few minutes postablation was significantly higher and more pronounced for nontransmural lesions.</div></div><div><h3>Conclusion</h3><div>This study shows that unipolar iEGMs can be used to differentiate between transmural and nontransmural atrial lesions within minutes after PFA in a porcine model, with implications for development of intraprocedural guidance of PFA procedures.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 3","pages":"Pages 350-361"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of atrial fibrillation in patients undergoing transcatheter aortic valve implantation","authors":"Jakob J. Reichl MD ,&nbsp;Thorald Stolte ,&nbsp;Jasper Boeddinghaus MD,&nbsp;Max Wagener MD,&nbsp;Gregor Leibundgut MD,&nbsp;Patrick Badertscher MD,&nbsp;Christian Sticherling MD,&nbsp;Michael Kühne MD,&nbsp;Christoph Kaiser MD,&nbsp;Felix Mahfoud MD,&nbsp;Thomas Nestelberger MD","doi":"10.1016/j.hroo.2024.12.016","DOIUrl":"10.1016/j.hroo.2024.12.016","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is the most common arrhythmia and an important risk factor for adverse cardiac outcomes, including heart failure and stroke. Moreover, AF has been linked to worse outcomes after transcatheter aortic valve implantation (TAVI). Real-world data on the impact of AF on outcomes after TAVI remain limited.</div></div><div><h3>Objective</h3><div>To assess the impact of AF on periprocedural and short-term outcomes after TAVI.</div></div><div><h3>Methods</h3><div>Patients undergoing TAVI at a tertiary center were consecutively included in a prospective registry. Cardiac rhythm at baseline was assessed using 12-lead ECGs. The primary outcome was all-cause mortality at 30 days. Secondary outcomes included all-cause mortality at 1 year, stroke at 30 days and 1 year, and procedural success, defined as freedom from periprocedural mortality, surgical re-interventions, re-interventions of the aortic valve, major access site complications, and periprocedural bleedings until discharge.</div></div><div><h3>Results</h3><div>Among 1655 patients undergoing TAVI, 428 patients (25.6%) had preexisting AF, and 77 patients (4.6%) were diagnosed with new-onset AF during hospitalization for TAVI. AF was not associated with higher mortality at 30 days (3.7% vs 2.0%; <em>P</em> = .054, adjusted hazard ratio [aHR], 1.8 [95% confidence interval (CI), 0.9–3.4]), but at 1 year (13.8% vs 8.4%; <em>P</em> = .001; aHR, 1.6 [95%CI, 1.2–2.2]). The stroke rate was higher in patients with AF at 30 days (5.9% vs 2.7%; <em>P</em> = .003; aHR, 2.1 [95%CI, 1.2–3.5]) and at 1 year (7.1% vs 3.8%; <em>P</em> = .005; aHR, 1.8 [95%CI, 1.2–2.9]). At discharge, 452 patients (89.5%) with AF received oral anticoagulation. After adjusting for anticoagulant therapy, the difference in stroke risk at 30 days (5.7% vs 2.3%; <em>P</em> = .058) and 1 year (6.8% vs 4.2%; <em>P</em> = .165) was no longer significant. Patients with AF experienced more major or life-threatening bleeding complications (14.2% vs 10.6%; <em>P</em> = .043). There were no differences in procedural success between patients with and those without AF (78.8% vs 78.3%; <em>P</em> = .886).</div></div><div><h3>Conclusion</h3><div>AF was associated with increased mortality at 1 year and higher rates of stroke and major bleeding at 30 days and 1 year after TAVI.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 3","pages":"Pages 273-279"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring posterosuperior bundle area pacing: A novel atrial pacing modality with efficient anatomical access, stable pacing lead fixation, and reserved interatrial synchrony","authors":"Zhaohui Qiu MD, PhD, FHRS ,&nbsp;Xianhao Wu MD ,&nbsp;Wei Hu MD, PhD ,&nbsp;Jing Ni MD, PhD ,&nbsp;Zhongping Yang PhD, FHRS ,&nbsp;Hongyang Lu PhD","doi":"10.1016/j.hroo.2024.11.027","DOIUrl":"10.1016/j.hroo.2024.11.027","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 3","pages":"Pages 383-387"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-glucose cotransporter-2 inhibitor use in type 2 diabetes mellitus is associated with a lower rate of atrial arrhythmias in a hospitalized real-world population","authors":"Kathryn D. Tiver BSc, BMBS ,&nbsp;Derek P. Chew MBBS, MPH, PhD ,&nbsp;Jia Y. Tan MBBS ,&nbsp;Kristina Lambrakis BSc ,&nbsp;Carmine G. De Pasquale BMBS, PhD ,&nbsp;Anand N. Ganesan MBBS, PhD","doi":"10.1016/j.hroo.2024.12.004","DOIUrl":"10.1016/j.hroo.2024.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have been associated with lower rates of cardiac arrhythmias in <em>post hoc</em> analyses. The real-world effect on cardiac arrhythmias is incompletely defined.</div></div><div><h3>Objective</h3><div>The purpose of this study was to determine the effects of SGLT2i on cardiac arrhythmias in a real-world, hospitalized population.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was performed in South Australia, Australia. Patients (n = 882) with type 2 diabetes mellitus (T2DM) on oral diabetic therapy (33.6% females, median age 62.3 years) who received SGLT2i (for T2DM) were identified through public hospital admissions from 2011–2019. Patients were matched with 3282 contemporaneous controls with T2DM who did not receive SGLT2i. Baseline characteristics were adjusted using inverse probability treatment weighting. The primary outcome was incidence of atrial arrhythmias. Secondary outcomes included incidence of ventricular arrhythmias and cardiac arrest at 2 years.</div></div><div><h3>Results</h3><div>All-cause mortality was higher in the SGLT2i group (hazard ratio [HR] 2.02, 95% confidence interval [CI] 1.55–2.63, <em>P</em> &lt;.001) despite propensity matching, highlighting the greater unmeasured comorbidity burden of the SGLT2i-treated group. Despite this, SGLT2i treatment was associated with fewer atrial arrhythmias (HR 0.17, 95% CI 0.07–0.41, <em>P</em> &lt;.001) at 2 years. The relationship between SGLT2i use and ventricular arrhythmias (HR 0.25, 95% CI 0.06–1.03, <em>P</em> = .055) and cardiac arrest (HR 0.82, 95% CI 0.20–3.45, <em>P</em> = .796) did not reach statistical significance.</div></div><div><h3>Conclusion</h3><div>In this real-world, comorbid inpatient cohort, SGLT2i treatment was associated with a lower incidence of atrial arrhythmias. Prospective randomized trials evaluating SGLT2i as specific atrial fibrillation pharmacotherapy are underway.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 3","pages":"Pages 299-306"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}