Abstract 4370041: Sodium-Glucose Cotransporter 2 Inhibitor on Atrial Fibrillation Recurrence after Catheter Ablation; A Systematic review and Meta-analysis.

Background: Recurrence of atrial fibrillation (AF) remains a concern even after catheter ablation. The impact of Sodium-Glucose Cotransporter 2 Inhibitor (SGLT2i) on Atrial tachyarrythmia free event remains unclear. Hypothesis: This analysis aims to analyze outcomes in patients treated with SGLT2i after catheter ablation. Methods: A meta-analysis of available studies comparing SGLT2i to non- SGLT2i group following ablation was conducted using electronic databases; PubMed and Embase until May 2025. A random-effects meta-analysis using the DerSimonian–Laird model was performed. Primary outcomes: tachyarrhythmia-free survival and secondary outcomes: all-cause hospitalization and all-cause mortality, and Relative risks (RR) with 95% confidence intervals (CI) were calculated with p <0.05 considered significant. Results: A total of 10 studies were included for meta-analysis with sample size of 10,985 (SGLT2i group: 5534 and non-SGLT2i group: 5451). Primary outcome: There was no significant difference in tachyarrhythmia-free survival (RR: 0.99, 95% CI: 0.76–1.29; p = 0.96), and high heterogeneity (I2 = 84.6%) was observed for this endpoint. Secondary outcome: SGLT2i therapy significantly reduced all-cause hospitalization (RR: 0.74, 95% CI: 0.59–0.94; p = 0.01; I2 = 36.4%) and all-cause mortality (RR: 0.64, 95% CI: 0.45–0.89; p = 0.01; I2 = 0%) Conclusion: SGLT2i therapy offers additive clinical benefits over non-SGLT2i group, notably in reducing hospitalizations and cardiovascular mortality. Its effect on arrhythmia prevention remains uncertain, highlighting the need for further investigation into patient selection and mechanistic interactions.