Abstract

Empagliflozin in paroxysmal or persistent atrial fibrillation: a possible antiarrhythmic effect

Highlights

  • Diabetes mellitus has been associated with coronary heart disease (CHD), but the possible correlation with arrhythmic diseases is a more recent concern

  • The post-hoc analysis of the DECLARE-TIMI 58 study conducted by Zelniker and colleagues, recently published in Circulation, for the first time demonstrated a favourable effect of treatment with the SGLT2 inhibitor dapagliflozin on the incidence of FA and FLA in patients with type 2 diabetes, independently of previous history of FA / FLA, atherosclerotic disease or heart failure [8]

  • Data of the present case-crossover study were retrospectively obtained from our database of patients affected by paroxysmal AF (PAF) or persistent AF (PeAF): from 2540 patients followed for atrial fibrillation (AF) by our cardiology unit, we extracted 23 consecutive subjects ICD wearers and affected by diabetes that started treatmentwith empagliflozin during the follow-up

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Summary

Introduction

Diabetes mellitus has been associated with coronary heart disease (CHD), but the possible correlation with arrhythmic diseases is a more recent concern. The post-hoc analysis of the DECLARE-TIMI 58 study conducted by Zelniker and colleagues, recently published in Circulation, for the first time demonstrated a favourable effect of treatment with the SGLT2 inhibitor dapagliflozin on the incidence of FA and FLA in patients with type 2 diabetes, independently of previous history of FA / FLA, atherosclerotic disease or heart failure [8]. The mechanisms underlying this effect are not yet well known and are probably multiple: from the natriuretic, diuretic and hemodynamic effect of these drugs that could prevent atrial dilation and cardiac remodelling, to the effects on blood pressure, body weight, oxidative stress and reduction of epicardial fat. In this study we evaluated a group of patients with paroxysmal AF (PAF) or persistent AF (PeAF) affected by type 2 diabetes and treated with empagliflozin

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