Ventricular Arrhythmia Events in Patients With Implantable Cardioverter–defibrillator Before and After the Treatment With Sodium–glucose Co–transporter 2 Inhibitors

Abstract Background Role of sodium–glucose co–transporter 2 inhibitors (SGLT2i) in the treatment of chronic heart failure is increasing. However, some case series described appropriate shocks from ICD in patients following the initiations of SGLT2i and a larger analysis is not present in the literature. Methods The aim of this study is to investigate the rate of ventricular arrhythmic burden and appropriate anti–tachycardia therapy from ICD before and after the initiation of SGLT2i therapy. A retrospective single–center analysis was performed, comparing ventricular events from home monitoring reports 3 months before and 3 months after SGLT2i therapy treatment. Results Seventeen patients were enrolled in the study. The baseline clinical e therapy characteristics of patients are shown in the table. Ten patients (59%) had mono cameral or dual cameral ICD and 7 had implantable cardiac resynchronization therapy (CRT) defibrillators.During the 3 months before SGLT2i treatment, 4/17 patients had nun–sustained ventricular tachycardia (NSVT) vs 8/17 (23% vs 47%, P value 0.23) patients with NSTV after the treatment. Seven patients (41%) had an increase in the rate of NSVT events (with a patient with 28 NSVT after treatment vs 0 before treatment). No patients had anti–tachycardia therapy in the 3 months before treatment, while during the 3 months after the SGLT2i treatment, 1 patient had a ventricular tachycardia treated with anti–tachycardia pacing (110 days after the beginning of the treatment) and 2 patients had a ventricular tachycardia treated with appropriate shock (2 and 25 days after the beginning of SGLT2i treatment). Conclusion This small retrospective analysis showed an increase in ventricular arrhythmic events in the 3 months after the initiation of SGLT2i. These data prospect the need for a larger analysis for a stronger statistical correlation.