SGLT2i therapy was associated with a significantly reduced risk of postablation atrial fibrillation recurrence compared to control (RR 0.65; 95% CI 0.58-0.72; P<0.0001).
Meta-Analysis (n=20,996)
Does SGLT2i therapy reduce postablation atrial fibrillation recurrence in patients with atrial fibrillation undergoing catheter ablation?
SGLT2 inhibitors are associated with a significant reduction in atrial fibrillation recurrence, all-cause mortality, and rehospitalization following catheter ablation.
Relative Risk: 0.65 (95% CI 0.58–0.72)
p-value: p=<0.0001
Postablation atrial fibrillation (AF) recurrence remains an important clinical challenge. Recent evidence suggests sodium-glucose cotransporter 2 inhibitors (SGLT2i) may reduce AF recurrence, but comprehensive data are limited. Electronic databases were systematically searched to identify studies evaluating clinical outcomes in patients with AF undergoing catheter ablation who received SGLT2i compared with those not receiving SGLT2i therapy. The primary outcome of interest was AF recurrence. Secondary outcomes included all-cause mortality and rehospitalization. Pooled effect estimates were calculated using random-effects models. The meta-analysis included 14 studies comprising 20,996 patients. Mean patient age was 65.9 ± 8.1 years, and mean follow-up duration was 16.4 months. SGLT2i therapy was associated with a significantly reduced risk of postablation AF recurrence compared to control (risk ratios RRs: 0.65, 95% confidence intervals CIs, 0.58–0.72, P < 0.0001). Secondary outcomes demonstrated reductions in all-cause mortality (RR: 0.67, 95% CI, 0.49–0.93, P = 0.01) and rehospitalizations (RR: 0.80, 95% CI, 0.72–0.88, P < 0.0001). Moderate heterogeneity was observed for the primary outcome ( I 2 = 47.6%), but subgroup analyses showed no significant interaction by study design ( P = 0.83). SGLT2i therapy is associated with a substantial reduction in postablation AF recurrence and improved cardiovascular outcomes. However, the evidence is predominantly observational; large-scale randomized controlled trials are needed to confirm these benefits and refine clinical guidelines.
Adnan et al. (2026) conducted a meta-analysis in Atrial fibrillation undergoing catheter ablation (n=20,996). Sodium-glucose cotransporter 2 inhibitors (SGLT2i) vs. Not receiving SGLT2i therapy was evaluated on Postablation AF recurrence (RR 0.65, 95% CI 0.58-0.72, p=<0.0001). SGLT2i therapy was associated with a significantly reduced risk of postablation atrial fibrillation recurrence compared to control (RR 0.65; 95% CI 0.58-0.72; P<0.0001).