Dapagliflozin to Reduce Early Recurrence After Catheter Ablation for Atrial Fibrillation: The DARE-AF Randomized Clinical Trial
Bibliographic record
Abstract
BACKGROUND: Observational studies have suggested that SGLT2 (sodium-glucose cotransporter 2) inhibitors are associated with a lower risk of atrial fibrillation (AF) recurrence after catheter ablation in patients with AF with concomitant diabetes, heart failure, or chronic kidney disease. However, no randomized trial to date has tested whether SGLT2 inhibitors reduce AF recurrence after ablation in patients without established indications. We therefore investigated the effect of dapagliflozin on prevention of early recurrence of AF after catheter ablation in patients without current indications for SGLT2 inhibitors. METHODS: The DARE-AF trial (Dapagliflozin on Recurrence After Catheter Ablation for Atrial Fibrillation) was a prospective, open-label, parallel-assignment randomized controlled trial that enrolled 200 patients with persistent AF between July 2024 and March 2025, scheduled to undergo a first catheter ablation procedure and without established indications for dapagliflozin (diabetes, heart failure, or chronic kidney disease). Patients were randomly assigned at a 1:1 ratio to dapagliflozin (10 mg once daily for 3 months after the ablation) or control. The primary end point was AF burden at 3 months after ablation, assessed by 7-day single-lead ECG patches. Secondary outcomes included time to events, quality of life, and improvement of atrial remodeling. RESULTS: A total of 200 patients (mean age 58.5 years, 19.5% women, 29.0% with persistent AF ≥1 year) were randomized, and 198 patients (98 in the dapagliflozin group, 100 in the control group) were included in the primary analysis. Three months after ablation, the difference in AF burden was insignificant between the dapagliflozin group and the control group (7.5±23.6% versus 8.1±25.5%; P =0.48). Atrial arrhythmia recurrence occurred in 29 patients (29.6%) in the dapagliflozin group and 28 patients (28.0%) in the control group (hazard ratio, 1.11 [95% CI, 0.66–1.86]; P =0.70). No significant between-group differences were observed in changes in quality of life or left atrial diameter. CONCLUSIONS: Three-month treatment with dapagliflozin did not reduce the early recurrence of arrhythmia after catheter ablation in patients with persistent AF. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT06433479.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".