Evaluation of the effect of SGLT-2 inhibitors on atrial fibrillation recurrence in diabetic patients.

Background: The aim of this study was to investigate the effect of SGLT-2 (sodium glucose cotransporter-2) inhibitors on AF (atrial fibrillation) recurrence in patients diagnosed with diabetes mellitus (DM) who underwent Direct Current Cardioversion (DCCV) in our clinic.

Research design and methods: Consecutive DCCV was performed to achieve 120 patients in SR (60 DM patients who used SGLT-2 inhibitors and 60 DM patients who didn't use SGLT-2 inhibitors). The two groups (SGLT-2 inhibitor user group and control group) were monitored for AF recurrence on the first day, then at one, three, and six months after CV.

Results: During the six-month follow-up period, AF recurrence developed in 24 (40%) patients in SGLT-2 inhibitor group and in 35 (58.3%) of the control group, p = 0.04. In univariable analysis, AF duration, non-use of SGLT-2 inhibitor, left atrium diameter, TAPSE value and in multivariable analysis, AF duration OR: 4.98; 95%CI (2.39-10.38), p < 0,001 and non-use of SGLT-2 inhibitors OR: 0.35; 95%CI (0.13-0.90), p = 0.03 were found to be independent predictors for AF recurrence.

Conclusion: AF recurrence ratio is significantly lower in patients using SGLT-2 inhibitors, in six-month follow-up period. AF duration and SGLT-2 inhibitor non-use were independent predictors, for AF recurrence in DM patients (NCT06951737).

Clinical trial registration: www.clinicaltrials.gov identifier is: NCT06951737.