Dapagliflozin to Prevent Atrial Fibrillation Recurrence After Transcatheter Pulmonary Venous Isolation.
Status:
Not yet recruiting
Trial end date:
2023-12-01
Target enrollment:
Participant gender:
Summary
Transcatheter left atrial antral ablation, aiming at complete electrical isolation of the
pulmonary veins (PVI), has become mainstay in atrial fibrillation (AF) treatment. This
approach has been proved superior to medical rhytmh control strategy in maintaining sinus
rhythm. Moreover PVI has been associated with significant survival benefit in patients with
heart failure and reduced left ventricular ejection fraction. Nevertheless, despite progress
in the field of catheter ablation, recurrence rates remain high.
Inhibitors of type 2 sodium- glucose co-transporter (SGLT2i) is a relatively recent addition
to the array of anti-diabetic agents, becoming part of everyday clinical practice. However,
although SGLT2i were first used solely as antidiabetics because of their glycosuric effect,
further research demonstrated that these drugs may independently reduce cardiovascular
events, especially in patients with heart failure, a benefit that was consistent among
diabetic and non-diabetic patients. Moreover, pleiotropic effects have been observed,
including a reno-protective action.
These findings suggest that SGLT2i mechanisms of action extend beyond the obvious increase in
urinary sodium and glucose excretion. Various studies propose that these drugs promote
favourable metabolic changes in myocardial energetics, while they also inhibit inflamation
and sympathetic activation, resulting in restriction of induced fibrosis and structural
remodeling, which are key elements in atrial fibrillation generation and maintenance.
These findings suggest that the use of SGLT2i could offer antiarrhythmic benefit by reducing
and/or reversing structural and electrical remodeling, leading to the assumption that use of
theese drugs could reduce recurrences after transcatheter AF ablation.
Phase:
Early Phase 1
Details
Lead Sponsor:
G.Gennimatas General Hospital
Collaborator:
2nd Department of Cardiology, "Attikon" University Hospital, National and Kapodistrian University of Athens