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July 15, 2023Journal of Cardiovascular Electrophysiology

Effect of sodium glucose cotransporter 2 inhibitors on atrial tachy‐arrhythmia burden in patients with cardiac implantable electronic devices

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Why the study?

SGLT2 inhibitors were associated with reduced atrial fibrillation hospitalizations, prompting evaluation of their effects on atrial tachy-arrhythmias in CIED patients.

Does SGLT2 inhibitor use reduce atrial tachy-arrhythmia burden in patients with cardiac implantable electronic devices?

Population

13 888 consecutive CIED patients at two tertiary medical centers

Comparison

SGLT2i use vs no SGLT2i use

Design

Two-center cohort study with blinded event adjudication and propensity score modeling

Follow-up

Total follow-up of 24 442 patient years

Key result

In patients with cardiac implantable electronic devices, SGLT2i use was associated with a reduced risk of atrial tachy-arrhythmias (HR 0.78; 95% CI 0.70-0.87; p<0.001).

Authors

AYArwa YounisTATania ArousRKRobert Klempfner

Discussion

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Member takes

Overview

May support arrhythmia reduction with SGLT2i in CIED patients; hypothesis-generating and requires randomized confirmation.

Key Points

  • This study aims to evaluate the effects of sodium glucose cotransporter 2 inhibitors on atrial tachy-arrhythmias in patients with cardiac implantable electronic devices.
  • Enrolled 13,888 patients with cardiac implantable electronic devices from two tertiary medical centers.
  • Evaluated SGLT2i treatment as a time-dependent variable with independent event adjudication.
  • Performed multivariable propensity score modeling to assess outcomes.
  • SGLT2i (N=696) was associated with a 22% reduction in risk of atrial tachy-arrhythmias (HR = 0.78, 95% CI = 0.70-0.87, p < .001).
  • Also associated with a 22% reduction in the risk of atrial and ventricular tachy-arrhythmias combined (HR = 0.78, 95% CI = 0.71-0.85, p < .001).
  • Showed a 35% reduction in all-cause mortality (HR = 0.65, 95% CI = 0.45-0.92, p = .015), but no significant association with ventricular tachy-arrhythmia risk.

Study Design

Type

Cohort (n=13,888)

Blinding

Blinded event adjudication

Multicenter

Yes

Structured PICO

Does SGLT2 inhibitor use reduce atrial tachy-arrhythmia burden in patients with cardiac implantable electronic devices?

P
Population
13,888 consecutive patients implanted with a cardiac implantable electronic device, followed for a total of 24,442 patient-years.
E
Exposure
Sodium glucose cotransporter 2 inhibitors (SGLT2i) (N = 696)
C
Comparator
Patients not treated with SGLT2 inhibitors
O
Outcome
Total number of atrial tachy-arrhythmias (ATA)surrogate

Main Result

Hazard Ratio: 0.78 (95% CI 0.7–0.87)

p-value: p=<.001

In patients with CIEDs, particularly those with heart failure, SGLT2 inhibitor use is associated with a significant reduction in atrial tachy-arrhythmia burden and all-cause mortality.

Cite This Study

Younis et al. (2023) conducted a cohort in Cardiac implantable electronic devices (CIEDs) (n=13,888). Sodium glucose cotransporter 2 inhibitors (SGLT2i) vs. No SGLT2i was evaluated on Total number of atrial tachy-arrhythmias (ATA) (HR 0.78, 95% CI 0.70-0.87, p=<.001). In patients with cardiac implantable electronic devices, SGLT2i use was associated with a reduced risk of atrial tachy-arrhythmias (HR 0.78; 95% CI 0.70-0.87; p<0.001).

synapsesocial.com/papers/6a600e2dc2662a747aa62e49https://doi.org/10.1111/jce.15996
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Impact of SGLT2 Inhibitors on Device-Detected Arrhythmias: a Preliminary Study2025 · 1 citations
  2. 2Association of Sodium-Glucose Cotransporter-2 Inhibitors With Atrial High-Rate Episodes in Patients With Cardiac Implantable Electronic Devices2026
  3. 3EFFECT OF SGLT2 INHIBITORS ON THE ARRHYTHMIC BURDEN IN HEART FAILURE2024 · 1 citations
  4. 4Effect of SGLT-2 inhibitors on arrhythmia events: insight from an updated secondary analysis of &gt; 80,000 patients (the SGLT2i—Arrhythmias and Sudden Cardiac Death)2024 · 54 citations
  5. 5Impact on ventricular arrhythmic burden of SGLT2 inhibitors in patients with chronic heart failure evaluated with cardiac implantable electronic device monitoring2024 · 11 citations