Impact of initiation of SGLT2 inhibitor treatment on the development of arrhythmias in patients with implantable cardiac devices

Carlos Minguito-Carazo; Enrique Sánchez Muñoz; Moisés Rodríguez Mañero; José Luis Martínez-Sande; María Luisa Fidalgo Andrés; Javier García Seara; José María González Rebollo; Miguel Rodríguez Santamarta; Laila González Melchor; Teba González Ferrero; Laura Romero Roche; Jesús Alberto Fernández López; Elena Tundidor Sanz; Felipe Fernández Vázquez; José Ramón González-Juanatey

doi:10.1016/j.rec.2023.12.010

Impact of initiation of SGLT2 inhibitor treatment on the development of arrhythmias in patients with implantable cardiac devices

Rev Esp Cardiol (Engl Ed). 2024 Jan 19:S1885-5857(24)00026-4. doi: 10.1016/j.rec.2023.12.010. Online ahead of print.

[Article in English, Spanish]

Authors

Carlos Minguito-Carazo¹, Enrique Sánchez Muñoz², Moisés Rodríguez Mañero³, José Luis Martínez-Sande⁴, María Luisa Fidalgo Andrés², Javier García Seara⁴, José María González Rebollo², Miguel Rodríguez Santamarta², Laila González Melchor⁴, Teba González Ferrero⁴, Laura Romero Roche², Jesús Alberto Fernández López⁴, Elena Tundidor Sanz², Felipe Fernández Vázquez², José Ramón González-Juanatey³

Affiliations

¹ Servicio de Cardiología, Hospital Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, A Coruña, Spain. Electronic address: carlosminguito@hotmail.es.
² Servicio de Cardiología, Complejo Asistencial Universitario de León, León, Spain.
³ Servicio de Cardiología, Hospital Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, A Coruña, Spain; Grupo de Cardiología Traslacional, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
⁴ Servicio de Cardiología, Hospital Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, A Coruña, Spain.

PMID: 38246269
DOI: 10.1016/j.rec.2023.12.010

Abstract

Introduction and objectives: Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) have been associated with improved prognosis in patients with heart failure, but their impact on atrial arrhythmic (AA) and ventricular arrhythmic (VA) events is not fully understood.

Methods: This multicenter retrospective study included patients with implantable cardioverter-defibrillators who initiated treatment with SGLT2i. AA and VA events were compared in 2 time periods for each patient: 1 year before and 1 year after starting SGLT2i.

Results: The study included 195 patients (66.8 [61.3-73.1] years, 18.5% women). In the post-SGLT2i period, there was a reduction in the percentage of patients with any VA (pre: 52.3% vs post: 30.3%; P<.001) and clinically relevant VA (excluding nonsustained ventricular tachycardia) (pre: 21.5% vs post: 8.7%; P<.001). There was also a decrease in the number of episodes per patient/y of nonsustained ventricular tachycardia (pre: 2 (1-5) vs post: 1 (0-2); P<.001) and sustained ventricular tachycardia (pre: 1 (1-3) vs post: 0 (0-2); P=0.046). However, no differences were observed in the prevalence of AA (24.7% vs 18.8%; P=.117) or the burden of atrial fibrillation (pre: 0% (0-0.1) vs post: 0% (0-0); P=.097).

Conclusions: Initiation of SGLT2i treatment was associated with a decrease in the percentage of patients with relevant VA but this effect was not observed for AA.

Keywords: Arritmias cardiacas; Cardiac arrhythmia; Cotransportador de sodio-glucosa tipo 2 (SGLT2); Dispositivo cardiaco implantable; Implantable cardiac device; Sodium glucose transporter 2 (SGLT2).