Dapagliflozin minimally beneficial for reducing AF recurrence postablation
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Treatment with dapagliflozin for 3 months falls short of reducing early recurrence of arrhythmia in patients with persistent atrial fibrillation (AF) who have undergone catheter ablation, according to the DARE-AF* trial.
DARE-AF included 200 patients (mean age 58.5 years, 19.5 percent female) with persistent AF (29 percent had AF persisting for ≥1 year) who were scheduled to undergo a first catheter ablation procedure and without established indications for dapagliflozin (diabetes, heart failure, or chronic kidney disease).
The patients were randomly assigned to receive dapagliflozin (intervention group) or standard care (control group). The intervention group took dapagliflozin 10 mg once daily for 3 months, with treatment started on the second day after the ablation procedure.
The primary endpoint of AF burden at 3 months after ablation was assessed using 7-day single-lead ECG patches. Secondary outcomes included time to events, quality of life, and improvement of atrial remodelling.
A total of 98 patients in the dapagliflozin group and 100 in the control group were included in the primary analysis. AF burden at 3 months postablation did not significantly differ between the dapagliflozin group and the control group (7.5 percent vs 8.1 percent; p=0.48).
Atrial arrhythmia recurrence occurred in 29.6 percent of patients in the dapagliflozin group vs 28 percent in the control group (hazard ratio, 1.11, 95 percent confidence interval, 0.66–1.86; p=0.70).
Changes in in quality of life and left atrial diameter were similar between the two treatment groups.