Impact of sodium-glucose cotransporter 2 inhibitors on recurrence and cardiovascular outcomes after catheter ablation for atrial fibrillation in patients with chronic kidney disease

Xu, H; Zhao, Z; Xu, Y; Jiang, C; Wang, X; Yang, Z; Yan, H; Shen, T; Guo, H; He, L; Guo, Q; Jiang, C; Tang, R; Sang, C; Long, D; Du, X; Dong, J; Ma, C

doi:10.1016/j.hrthm.2025.08.015

Arrhythmias & electrophysiology

Impact of sodium-glucose cotransporter 2 inhibitors on recurrence and cardiovascular outcomes after catheter ablation for atrial fibrillation in patients with chronic kidney disease

Heart RhythmPublished 14 Aug 2025prospective Chinese Atrial Fibrillation Registry

Main finding · AF recurrence after the 3-month blanking periodResultAdjusted hazard ratio 0.56 95% CI 0.32–0.98

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Authors' conclusion

SGLT2i treatment was associated with reduced risks of AF recurrence and the composite outcome (cardiovascular mortality, cardiovascular hospitalization, or thrombotic events) in patients with CKD undergoing catheter ablation for AF.

Study context

Population: Patients with atrial fibrillation (AF) and chronic kidney disease (CKD) undergoing initial catheter ablation from January 2019 to December 2023patients with AF and CKD undergoing initial catheter ablation
Participants: 628 patients

Exposure: SGLT2i group vs non-SGLT2i group
SGLT2i groupn = 119
non-SGLT2i groupn = 509reference
Outcome: AF recurrence after the 3-month blanking period
Follow-up: Mean of 13.1 ± 5.3 months

Methodological detailsPropensity score-derived overlap weighting

Propensity score-derived overlap weighting

Main finding

As reported in the abstract

Adjusted hazard ratio

0.56

95% CI 0.32–0.98

P = 0.044

Events by group

SGLT2i group21.8%26 of 119 of 119

non-SGLT2i group31.2%159 of 509 of 509

SGLT2i group vs non-SGLT2i group

adjusted HR 0.56 (95% CI 0.32–0.98); P = 0.044

Observational data: associations, not effects.

Further findings

Outcome	← Lower risk with SGLT2i group ←→ Higher risk with SGLT2i group →	Adjusted HR (95% CI)	P value
Composite outcome (cardiovascular mortality, cardiovascular hospitalization, or thrombotic events)	0.10.31310	0.38 (0.20–0.73)	P = 0.004
Cardiovascular hospitalization	0.10.31310	0.33 (0.16–0.68)	P = 0.002
	0.10.31310Adjusted hazard ratio (log scale)

Original publication

Impact of sodium-glucose cotransporter 2 inhibitors on recurrence and cardiovascular outcomes after catheter ablation for atrial fibrillation in patients with chronic kidney disease. Heart Rhythm. Published 14 August 2025. doi:10.1016/j.hrthm.2025.08.015

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