Can SGLT2 Inhibitors Prevent Atrial Fibrillation in HFpEF?

Blent zlekHeart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) frequently coexist, sharing key risk factors such as aging, obesity, diabetes, and hypertension. 1,2When present together, they contribute synergistically to increased morbidity and mortality.AF is observed in 40%-60% of HFpEF patients and is associated with worsened prognosis due to heightened symptom burden, increased hospitalizations, and elevated thromboembolic risk.Despite advancements in HFpEF management, strategies to prevent newonset AF or reduce its recurrence remain inadequate.Recently, sodium-glucose cotransporter-2 inhibitors (SGLT2i) have become a cornerstone in HFpEF treatment, improving the outcomes regardless of the diabetes status. 3 Their pleiotropic cardiometabolic effects have generated growing interest in their potential role in AF prevention.