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2026, Vol: 10, Issue: 7
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Review Article
Online Published: 30 Nov 2025
 


Efficacy and safety of empagliflozin to reduce atrial fibrillation episodes: systematic review

Hyder Osman Mirghani, Wejdan Ahmed Aldawsari, Abdulmalik Khaled Albalawi, Khalid Ahmed Aldawsari, Ryan Mohammed M. Alqahtani, Asiri Abdullah Hassan A, Hamad Saud Sultan, Bandar Mohammed F Alanazi, Yazeed Mohammed A Alanazi, Hanan Saud O Almarwani, Waleed Thaqal S Alotaibi, Alenzi Saleh Abdulrhman S, Abdulkarim Omar Abdullah Althobaiti, Saleh Mohammed Suliman Alatawi.


Abstract
Atrial fibrillation (AF) is a prevalent arrhythmia with significant morbidity and mortality. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, like empagliflozin, have demonstrated cardioprotective benefits, but their specific efficacy for reducing AF episodes has not been systematically evaluated. This systematic review aimed to synthesize the existing evidence on the efficacy and safety of empagliflozin for reducing atrial fibrillation episodes across various patient populations. A comprehensive search was conducted from 2020 to 2025, following PRISMA guidelines. Studies that assessed the impact of empagliflozin on AF incidence, recurrence, burden, or post-operative AF (POAF). Six studies were included, indicating that empagliflozin significantly reduce the composite risk of cardiovascular death or heart failure hospitalization in patients with and without pre-existing AF, with a larger absolute benefit in high-risk AF subgroups. For specific AF outcomes, a trend towards reduced POAF was observed, alongside a significant reduction in post-operative ventricular arrhythmias and inflammation. One real-world study suggested a potential difference in AF efficacy within the SGLT2 inhibitor class, favoring dapagliflozin. The safety profile of empagliflozin was consistent with its known pharmacology and was not associated with increased serious adverse events, even in surgical populations. The empagliflozin demonstrated a beneficial effect on reducing AF-related complications, primarily driven by its profound impact on heart failure outcomes. Emerging evidence suggests a role in primary AF prevention, potentially mediated through anti-inflammatory, anti-fibrotic, and hemodynamic mechanisms. While the overall safety profile is favorable, questions regarding comparative efficacy within the SGLT2 inhibitor class remain.

Key words: Atrial fibrillation, empagliflozin, SGLT2 inhibitor, systematic review, arrhythmia, heart failure


 
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How to Cite this Article
Pubmed Style

Mirghani HO, Aldawsari WA, Albalawi AK, Aldawsari KA, Alqahtani RMM, A AAH, Sultan HS, Alanazi BMF, Alanazi YMA, Almarwani HSO, Alotaibi WTS, S ASA, Althobaiti AOA, Alatawi SMS. Efficacy and safety of empagliflozin to reduce atrial fibrillation episodes: systematic review. IJMDC. 2025; 9(11): 2833-2841. doi:10.24911/IJMDC.51-1758187996

Web Style

Mirghani HO, Aldawsari WA, Albalawi AK, Aldawsari KA, Alqahtani RMM, A AAH, Sultan HS, Alanazi BMF, Alanazi YMA, Almarwani HSO, Alotaibi WTS, S ASA, Althobaiti AOA, Alatawi SMS. Efficacy and safety of empagliflozin to reduce atrial fibrillation episodes: systematic review. https://www.ijmdc.com/?mno=284804 [Access: June 27, 2026]. doi:10.24911/IJMDC.51-1758187996

AMA (American Medical Association) Style

Mirghani HO, Aldawsari WA, Albalawi AK, Aldawsari KA, Alqahtani RMM, A AAH, Sultan HS, Alanazi BMF, Alanazi YMA, Almarwani HSO, Alotaibi WTS, S ASA, Althobaiti AOA, Alatawi SMS. Efficacy and safety of empagliflozin to reduce atrial fibrillation episodes: systematic review. IJMDC. 2025; 9(11): 2833-2841. doi:10.24911/IJMDC.51-1758187996


Vancouver/ICMJE Style

Mirghani HO, Aldawsari WA, Albalawi AK, Aldawsari KA, Alqahtani RMM, A AAH, Sultan HS, Alanazi BMF, Alanazi YMA, Almarwani HSO, Alotaibi WTS, S ASA, Althobaiti AOA, Alatawi SMS. Efficacy and safety of empagliflozin to reduce atrial fibrillation episodes: systematic review. IJMDC. (2025), [cited June 27, 2026]; 9(11): 2833-2841. doi:10.24911/IJMDC.51-1758187996


Harvard Style

Mirghani, H. O., Aldawsari, . W. A., Albalawi, . A. K., Aldawsari, . K. A., Alqahtani, . R. M. M., A, . A. A. H., Sultan, . H. S., Alanazi, . B. M. F., Alanazi, . Y. M. A., Almarwani, . H. S. O., Alotaibi, . W. T. S., S, . A. S. A., Althobaiti, . A. O. A. & Alatawi, . S. M. S. (2025) Efficacy and safety of empagliflozin to reduce atrial fibrillation episodes: systematic review. IJMDC, 9 (11), 2833-2841. doi:10.24911/IJMDC.51-1758187996


Turabian Style

Mirghani, Hyder Osman, Wejdan Ahmed Aldawsari, Abdulmalik Khaled Albalawi, Khalid Ahmed Aldawsari, Ryan Mohammed M. Alqahtani, Asiri Abdullah Hassan A, Hamad Saud Sultan, Bandar Mohammed F Alanazi, Yazeed Mohammed A Alanazi, Hanan Saud O Almarwani, Waleed Thaqal S Alotaibi, Alenzi Saleh Abdulrhman S, Abdulkarim Omar Abdullah Althobaiti, and Saleh Mohammed Suliman Alatawi. 2025. Efficacy and safety of empagliflozin to reduce atrial fibrillation episodes: systematic review. International Journal of Medicine in Developing Countries, 9 (11), 2833-2841. doi:10.24911/IJMDC.51-1758187996


Chicago Style

Mirghani, Hyder Osman, Wejdan Ahmed Aldawsari, Abdulmalik Khaled Albalawi, Khalid Ahmed Aldawsari, Ryan Mohammed M. Alqahtani, Asiri Abdullah Hassan A, Hamad Saud Sultan, Bandar Mohammed F Alanazi, Yazeed Mohammed A Alanazi, Hanan Saud O Almarwani, Waleed Thaqal S Alotaibi, Alenzi Saleh Abdulrhman S, Abdulkarim Omar Abdullah Althobaiti, and Saleh Mohammed Suliman Alatawi. "Efficacy and safety of empagliflozin to reduce atrial fibrillation episodes: systematic review." International Journal of Medicine in Developing Countries 9 (2025), 2833-2841. doi:10.24911/IJMDC.51-1758187996


MLA (The Modern Language Association) Style

Mirghani, Hyder Osman, Wejdan Ahmed Aldawsari, Abdulmalik Khaled Albalawi, Khalid Ahmed Aldawsari, Ryan Mohammed M. Alqahtani, Asiri Abdullah Hassan A, Hamad Saud Sultan, Bandar Mohammed F Alanazi, Yazeed Mohammed A Alanazi, Hanan Saud O Almarwani, Waleed Thaqal S Alotaibi, Alenzi Saleh Abdulrhman S, Abdulkarim Omar Abdullah Althobaiti, and Saleh Mohammed Suliman Alatawi. "Efficacy and safety of empagliflozin to reduce atrial fibrillation episodes: systematic review." International Journal of Medicine in Developing Countries 9.11 (2025), 2833-2841. Print. doi:10.24911/IJMDC.51-1758187996


APA (American Psychological Association) Style

Mirghani, H. O., Aldawsari, . W. A., Albalawi, . A. K., Aldawsari, . K. A., Alqahtani, . R. M. M., A, . A. A. H., Sultan, . H. S., Alanazi, . B. M. F., Alanazi, . Y. M. A., Almarwani, . H. S. O., Alotaibi, . W. T. S., S, . A. S. A., Althobaiti, . A. O. A. & Alatawi, . S. M. S. (2025) Efficacy and safety of empagliflozin to reduce atrial fibrillation episodes: systematic review. International Journal of Medicine in Developing Countries, 9 (11), 2833-2841. doi:10.24911/IJMDC.51-1758187996




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