Why the study?
The association of SGLT2 inhibitors with device-adjudicated ventricular arrhythmias in real-world primary-prevention ICD recipients remains poorly characterized.
Does SGLT2 inhibitor use reduce the incidence of appropriate ICD shocks in primary-prevention ICD recipients?
Population
62 primary-prevention ICD recipients
Comparison
SGLT2i at implantation vs no SGLT2i
Design
Single-center prospectively maintained registry cohort study
Follow-up
Median 752 days
Key result
SGLT2 inhibitor use at ICD implantation was associated with a lower hazard of first appropriate ICD shock (HR 0.34; 95% CI 0.13-0.91; p=0.031), though attenuated after adjusting for baseline NSVT.
Authors
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May support fewer appropriate shocks despite comorbidities in ICD recipients; leaves open causality and practice change pending larger trials.
Cohort (n=62)
No
Does SGLT2 inhibitor use reduce the incidence of appropriate ICD shocks in primary-prevention ICD recipients?
Hazard Ratio: 0.34 (95% CI 0.13–0.91)
p-value: p=0.031
SGLT2 inhibitor use at the time of primary-prevention ICD implantation is associated with fewer appropriate shocks, though this association may be confounded by baseline arrhythmic burden.
Guzman et al. (2026) conducted a cohort in Primary-prevention ICD recipients (n=62). SGLT2 inhibitors vs. Untreated patients was evaluated on First appropriate ICD shock for sustained ventricular tachyarrhythmia (HR 0.34, 95% CI 0.13-0.91, p=0.031). SGLT2 inhibitor use at ICD implantation was associated with a lower hazard of first appropriate ICD shock (HR 0.34; 95% CI 0.13-0.91; p=0.031), though attenuated after adjusting for baseline NSVT.
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