Impact of GLP-1 Receptor Agonist Therapy on Atrial Fibrillation Recurrence After Catheter Ablation in Obese Patients: A Real-World Data Analysis

Q: What are the key findings of this study?

GLP-1 receptor agonist therapy reduced atrial fibrillation recurrence by 14% (6.66% vs 7.72%; HR 0.82) in obese patients after catheter ablation.

Q: What does this research mean for the field?

GLP-1 receptor agonist therapy reduces atrial fibrillation recurrence by 14% in obese patients after catheter ablation. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Sandrine Venier; P Defaye; Lisa Lochon; Rémi Benali; A. Bisson; Adrien Carabelli; Youssou Diouf; Peggy Jacon; Laurent Fauchier

doi:10.1161/circep.125.014101

December 25, 2025Circulation Arrhythmia and ElectrophysiologyOpen Access

Impact of GLP-1 Receptor Agonist Therapy on Atrial Fibrillation Recurrence After Catheter Ablation in Obese Patients: A Real-World Data Analysis

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Key result

GLP-1RA therapy linked to ~18% lower AF recurrence in obese patients after catheter ablation.

6.66% vs 7.72%
HR 0.82

Figures

Why the study?

Recent data suggest GLP-1 receptor agonists have anti-arrhythmic effects, but their impact on AF recurrence after catheter ablation in obese patients remains underexplored.

Does GLP-1 receptor agonist therapy reduce atrial fibrillation recurrence in obese patients undergoing catheter ablation?

Key Points

To evaluate whether GLP-1 receptor agonist therapy is associated with reduced atrial fibrillation recurrence and improved clinical outcomes in obese patients following catheter ablation.
Retrospective cohort study using the TriNetX multicenter research network containing de-identified electronic health records from >100 million patients.
Included adult patients (age ≥18 years) with obesity (body mass index >30 kg/m²) who underwent atrial fibrillation ablation between January 2015 and January 2025.
Performed 1:1 propensity score matching across 82 variables, comparing GLP-1RA users (n=3350) to nonusers (n=3350) over a median follow-up of 2 years (interquartile range, 0.8–3.2).
AF recurrence was significantly lower in GLP-1RA users compared with nonusers (6.66% versus 7.72%; HR, 0.82 [95% CI, 0.76–0.88]; P <0.0001).
Progression to permanent AF occurred less frequently among GLP-1RA users (3.16% versus 3.38%; HR, 0.77 [95% CI, 0.63–0.93]; P =0.01).
GLP-1RA users experienced lower risks of all-cause mortality (HR, 0.73 [95% CI, 0.59–0.91]; P =0.01), heart failure hospitalization (HR, 0.80 [95% CI, 0.71–0.90]; P <0.0001), and cardiovascular hospitalization (HR, 0.85 [95% CI, 0.77–0.93]; P =0.001).

Structured PICO

Does GLP-1 receptor agonist therapy reduce atrial fibrillation recurrence in obese patients undergoing catheter ablation?

P

Population

6,700 adult patients (aged 18-90 years) with documented obesity (BMI ≥30 kg/m²) who underwent atrial fibrillation (AF) ablation between January 2015 and March 2025. Excluded patients with a history of prior AF ablation.

I

Intervention

GLP-1 receptor agonist therapy (semaglutide, liraglutide, dulaglutide, exenatide, lixisenatide, or tirzepatide) prescribed within 1 year before or up to 6 months after the index ablation.

C

Comparator

No GLP-1RA exposure during the same timeframe, matched 1:1 using propensity score matching across 82 clinical and demographic variables.

O

Outcome

Recurrence of AF, defined as hospitalization or outpatient visit coded for AF, assessed up to 6 years postablation.hard clinical

In obese patients undergoing AF ablation, GLP-1RA therapy is associated with a significantly lower risk of AF recurrence, progression to permanent AF, cardiovascular hospitalizations, and all-cause mortality.

Limitations

Retrospective nature precludes causal inference
Use of administrative data may underestimate true burden of AF due to lack of systematic ECG adjudication
Could not measure precise degree of weight loss or duration of therapy
Could not confirm patient compliance or dose effect
Residual confounding possible despite robust propensity score matching

Implication

May support adjunctive GLP-1RA use post-AF ablation; extends observational data but leaves open randomized confirmation.

Abstract

BACKGROUND: GLP-1 (glucagon-like peptide-1) receptor agonists (GLP-1RAs), initially developed for glycemic control in type 2 diabetes, have shown cardiometabolic benefits including weight loss, improved endothelial function, and reduced inflammation. Recent data suggest potential anti-arrhythmic effects via modulation of atrial substrate and autonomic tone. Their impact on obese, nondiabetic patients remains underexplored. This study examines whether GLP-1RA use is associated with reduced atrial fibrillation recurrence after catheter ablation in obese patients, using real-world data from a large multicenter database. METHODS: We conducted a retrospective cohort study using the TriNetX research network, which contains de-identified electronic health records from >100 million patients. Adult patients (age ≥18 years) with obesity (body mass index >30 kg/m²) who underwent atrial fibrillation (AF) ablation between January 2015 and January 2025 were eligible. The cohort was divided into GLP-1RA users (n=3350) and nonusers (n=3350), with 1:1 propensity score matching performed across 82 clinical and demographic variables, including age, sex, race, AF subtype, cardiovascular comorbidities, and baseline medications. RESULTS: During a median follow-up of 2 years (interquartile range,0.8–3.2) AF recurrence was significantly lower in GLP-1RA users versus non users (6.66% versus 7.72%; hazard ratio [HR], 0.82 [95% CI, 0.76–0.88]; P <0.0001) Progression to permanent AF occurred less frequently in GLP-1RA users (3.16% versus 3.38%; HR, 0.77 [95% CI, 0.63–0.93]; P =0.01). Risk of all-cause mortality was lower in the GLP-1RA group (HR, 0.73 [95% CI, 0.59–0.91]; P =0.01) HF hospitalization (HR, 0.80 [95% CI, 0.71–0.90]; P <0.0001) and cardiovascular hospitalizations (HR, 0.85 [95% CI, 0.77–0.93]; P =0.001) were also significantly lower with GLP-1RA use. No significant difference was found for redo ablation. CONCLUSIONS: In a large real-world cohort of obese patients undergoing catheter ablation for AF, GLP-1RA therapy was associated with lower risks of AF recurrence, progression to permanent AF, cardiovascular hospitalizations, and mortality.

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Cite This Study

Venier et al. (2025) studied this question. GLP-1 receptor agonist therapy reduced atrial fibrillation recurrence by 14% (6.66% vs 7.72%; HR 0.82) in obese patients after catheter ablation.

synapsesocial.com/papers/6963222391e05aa366cb8a77 https://doi.org/10.1161/circep.125.014101