Key result
In heart failure patients with a baseline arrhythmic phenotype, SGLT2 inhibitors significantly reduced non-sustained ventricular tachycardia (32% vs 68%, p=0.022) but not MAACE (28% vs 36%, p=0.727).
Why the study?
Previous studies yielded conflicting data regarding the effects of SGLT2 inhibitors on ventricular arrhythmias in patients with heart failure.
Do SGLT2 inhibitors reduce major adverse arrhythmic cardiac events in patients with chronic heart failure evaluated with cardiac implantable electronic device monitoring?
Observational (n=82)
Do SGLT2 inhibitors reduce major adverse arrhythmic cardiac events in patients with chronic heart failure evaluated with cardiac implantable electronic device monitoring?
SGLT2 inhibitors may have anti-arrhythmic properties, significantly reducing non-sustained ventricular tachycardia in heart failure patients with a pre-existing arrhythmic phenotype.
Answers are grounded in this paper and cite their sources.
SGLT2 inhibitors were not associated with lower MAACE; hypothesis-generating for NSVT reduction, warranting randomized confirmation before practice change.
BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have revolutionized the therapeutic scenario of heart failure, demonstrating favorable effects on mortality and quality of life. Previous studies have yielded conflicting data regarding the effects on ventricular arrhythmias. METHODS: A prospective observational study was conducted to investigate the anti-arrhythmic properties of SGLT2 inhibitors evaluating the intra-patient difference in major adverse arrhythmic cardiac events (MAACE) over a six-month period in patients with chronic heart failure who were undergoing continuous monitoring using a cardiac implantable electronic device. RESULTS: From January 2022 to January 2023, 82 patients [median age 63 years (IQR 15), male 87 %] were enrolled in the study, with a median follow-up of 28 weeks (IQR 5). The rate of MAACE at baseline was 11 %, without relevant differences in the follow up in terms of major and minor arrhythmic events. In patients with an arrhythmic phenotype at baseline, a mild but non statistically significant reduction of MAACE (from 36 % to 28 %, p = 0.727) was observed and a significant decrease of non-sustained ventricular tachycardia (from 68 % to 32 %, p = 0.022). CONCLUSIONS: Our findings suggest potential anti-arrhythmic properties of SGLT2 inhibitors, evident in patients with arrhythmic events before the initiation of the drug.
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Basile et al. (2024) conducted an observational in chronic heart failure (n=82). SGLT2 inhibitors vs. Baseline (intra-patient comparison) was evaluated on Major adverse arrhythmic cardiac events (MAACE) in patients with an arrhythmic phenotype (p=0.727). In heart failure patients with a baseline arrhythmic phenotype, SGLT2 inhibitors significantly reduced non-sustained ventricular tachycardia (32% vs 68%, p=0.022) but not MAACE (28% vs 36%, p=0.727).
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