AUTHOR=Li Jiaqi , Zhang Fan , Fan Shaobo , Yan Yingchuan , Zhang Jie , Zhang Enyuan , Wu Dongyan , Lu Fengmin , Xu Jing , Ma Wei 

TITLE=Association of SGLT2 inhibitors with post-ablation atrial fibrillation recurrence in individuals with heart failure or type 2 diabetes mellitus: a systematic review and meta-analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1710123

DOI=10.3389/fcvm.2025.1710123

ISSN=2297-055X

ABSTRACT=BackgroundThe impact of sodium–glucose cotransporter-2 inhibitors (SGLT2i) on post-ablation atrial fibrillation (AF) recurrence is still unclear. Accordingly, we investigated whether exposure to SGLT2i reduces post-ablation AF recurrence among individuals with heart failure (HF) or type 2 diabetes mellitus (T2DM).MethodsWe carried out a structured search of PubMed, Embase, and the Cochrane Library from database launch through August 17, 2025. Pooled analyses were generated with RevMan 5.4 and Stata 18.Results11 studies were included, comprising 2 randomized controlled trials (RCTs) and 9 retrospective cohort studies, with a total of 7,664 individuals. Among them, 3,390 received SGLT2i therapy, and 4,274 received non-SGLT2i therapy. Compared with the non-SGLT2i, SGLT2i was linked to decreased post-ablation AF recurrence (RR: 0.61, 95% CI: 0.52–0.71, p < 0.001). Subgroup analyses showed consistent reductions in recurrence risk in individuals with AF and T2DM (RR: 0.74, 95% CI: 0.68–0.80, p < 0.001) as well as those with AF and HF (RR: 0.61, 95% CI: 0.50–0.74, p < 0.001). Furthermore, SGLT2i corresponded to reduced all-cause mortality (RR: 0.66, 95% CI: 0.48–0.91, p = 0.010), fewer rehospitalization (RR: 0.79, 95% CI: 0.72–0.88, p < 0.001), and a lower incidence of thromboembolic events (RR: 0.56, 95% CI: 0.36–0.86, p = 0.009).ConclusionsUse of SGLT2i was linked to reduced post-ablation AF recurrence, and this association was consistent in AF individuals with T2DM as well as those with HF. Additionally, SGLT2i therapy correlated with reduced risks of all-cause mortality, rehospitalization, and thromboembolic events.Systematic Review Registrationidentifier CRD420251125971.