Effect of Sodium-Glucose Cotransporter Type 2 Inhibitors on The Development and Course of Atrial Fibrillation

Atrial fibrillation is one of the most common heart rhythm disorders associated with an increased risk of stroke, cardiovascular mortality and hospitalizations. The development of arrhythmias is influenced by a number of risk factors, including arterial hypertension, chronic heart failure, coronary heart disease and endocrine disorders. New guidelines from the European Society of Cardiology (2024) emphasize the importance of managing risk factors to improve treatment efficacy and prognosis in patients with atrial fibrillation. Sodium-glucose cotransporter type 2 inhibitors (gliflozins), originally used as hypoglycemic drugs, are now also widely used to reduce the risk of adverse cardiovascular events. However, the use of these drugs to reduce the risk of atrial fibrillation and improve the course of atrial fibrillation remains an open question. In order to find an answer to this question, a literature review was conducted, which showed that inhibitors of sodium-glucose cotransporter type 2 can theoretically have an antiarrhythmic effect realized through several mechanisms. Analysis of scientific data suggests that in most cases, the use of sodium-glucose cotransporter type 2 inhibitors reduces the risk of first-time atrial fibrillation, has a positive effect on the course of arrhythmia and reduces the risk of its recurrence after ablation. At the same time, it is not clear to the end whether the discussed issues are class-effect or the drugs belonging to the gliflozin group have different efficacy. The mentioned issues necessitate further prospective studies to confirm the antiarrhythmic effect in sodiumglucose cotransporter type 2 inhibitors.

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