GLP-1 RA use reduced the risk of atrial fibrillation recurrence after ablation by 28% (HR 0.72) in obese patients, with a lower likelihood of mortality (HR 0.61) at 12 months.
Does baseline GLP-1 RA use reduce the recurrence of AF (measured by cardioversion, new AAD therapy, or redo ablation) in obese patients undergoing AF ablation?
In obese patients undergoing AF ablation, baseline use of GLP-1 receptor agonists is associated with a significantly lower risk of arrhythmia recurrence and 12-month mortality.
ABSTRACT Background Obesity is an important risk factor associated with atrial fibrillation (AF). The impact of glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) on recurrent AF among patients undergoing catheter ablation is not well described. Objective This study aimed to evaluate the effect of GLP‐1 RA on the recurrence of AF among obese patients after catheter ablation. Methods Utilizing the TriNetX research network, we identified patients aged over 18 with obesity (BMI ≥ 30) who underwent AF ablation from January 1, 2015, to December 1, 2022, using Current Procedural Terminology codes. Patients were categorized based on their baseline GLP‐1 RA use. Through propensity‐score matching, each cohort comprised 1558 patients. The primary outcome encompassed a composite of cardioversion, initiation of new antiarrhythmic drug (AAD) therapy, or redo AF ablation. Additional outcomes during the 12‐month follow‐up included AF readmission, heart failure readmissions, readmissions due to ischemic stroke, and mortality, with a separate analysis done for patients with BMI > 40. Results GLP‐1 RA use in patients with obesity undergoing AF ablation was linked to a significantly reduced risk of cardioversion, new AAD therapy, and the need for redo AF ablation (hazard ratio HR 0.72 0.65–0.80; p 40, although apart from ischemic stroke, there was no difference in mortality between the two groups. Conclusion The utilization of GLP‐1 RA in individuals with obesity is linked to a decreased likelihood of arrhythmia recurrence following AF ablation, leading to a reduced requirement for cardioversion, AAD therapy, or redo AF ablation.
Patel et al. (2025) studied this question. GLP-1 RA use reduced the risk of atrial fibrillation recurrence after ablation by 28% (HR 0.72) in obese patients, with a lower likelihood of mortality (HR 0.61) at 12 months.