Abstract Body (Do not enter title and authors here): Background: Observational studies have suggested that sodium-glucose cotransporter 2 inhibitors (SGLT2i) are associated with a lower risk of atrial fibrillation (AF) recurrence after catheter ablation in AF patients with concomitant diabetes or heart failure. However, the effect of SGLT2i on AF recurrence in patients without its established indications remains unknown. This study aimed to evaluate the effect of dapagliflozin on AF recurrence after catheter ablation in patients without diabetes or heart failure.
Methods:
DARE-AF (Dapagliflozin on Recurrence After Catheter Ablation for Atrial Fibrillation) trial was a prospective, open-label, parallel-assignment randomized controlled trial that enrolled 200 persistent AF patients scheduled to undergo de novo catheter ablation without established indications for dapagliflozin (diabetes, heart failure, or chronic kidney disease). The trial is registered on ClinicalTrials.gov (NCT06433479). Patients were randomly assigned in a 1:1 ratio to dapagliflozin 10mg once daily for 3 months after the ablation or control. The primary endpoint was AF burden at 3 months after ablation, assessed by 7-day single-lead electrocardiogram patches. Secondary outcomes included time to events, quality of life, and improvement of atrial remodeling. The main results will be presented.
Conclusions: The DARE-AF trial will provide robust evidence on whether SGLT2i can reduce AF burden following catheter ablation in patients without conventional treatment indications. Findings from this trial may clarify whether the observed antiarrhythmic effects of SGLT2i are independent of underlying cardiometabolic comorbidities and inform future strategies to optimize rhythm control after ablation, potentially expanding the therapeutic role of SGLT2 inhibitors in AF management.