September 10, 2026Journal of the American Heart Association0 citationsOpen Access
Tirzepatide and the Incidence of Atrial Fibrillation in Adults With Overweight or Obesity: An Updated Meta‐Analysis of Randomized Controlled Trials
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Key Result
Tirzepatide was not associated with an increased incidence of atrial fibrillation (OR 2.20; 95% CrI 0.81-6.75) compared to placebo in adults with overweight or obesity.
Key Points
- To evaluate whether tirzepatide is associated with an increased incidence of atrial fibrillation or other arrhythmias in adults with overweight or obesity.
- Systematic search of PubMed, Embase, and Cochrane Library identified 10 randomized controlled trials comparing tirzepatide with placebo in adults with overweight or obesity (N=6,515; 4,491 assigned to tirzepatide).
- Pooled odds ratios (ORs) with 95% credible intervals (CrIs) were calculated using a Bayesian binomial-normal hierarchical model suited for rare-event outcomes.
- Tirzepatide was not significantly associated with atrial fibrillation (pooled OR 2.20; 95% CrI, 0.81–6.75) or atrial arrhythmia (pooled OR 2.16; 95% CrI, 0.90–5.87).
- Tirzepatide was associated with higher odds of any arrhythmia (pooled OR 1.84; 95% CrI, 1.04–3.90), though overall event rates across trials were low.
Study Design
Type
Meta-Analysis (n=6,515)
Structured PICO
Does tirzepatide increase the incidence of atrial fibrillation in adults with overweight or obesity?
P
Population
6,515 adults with overweight or obesity included across 10 randomized controlled trials.
I
Intervention
Tirzepatide
C
Comparator
Placebo
O
Outcome
Incidence of atrial fibrillationsafety
Tirzepatide is not significantly associated with an increased risk of atrial fibrillation or atrial arrhythmias in overweight or obese adults, though a slight increase in overall arrhythmias was observed and warrants cautious interpretation.
Main Result
Odds Ratio: 2.2 (95% CI 0.81–6.75)
Limitations
- Event rates were low and the findings should be interpreted cautiously
- low event rates
Abstract
BACKGROUND: Tirzepatide is a dual agonist for glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors, with proven efficacy in weight loss and improvement in cardiovascular outcomes. However, the effects of tirzepatide on the incidence of atrial fibrillation in patients with overweight or obesity remain unclear. METHODS: PubMed, Embase, and Cochrane Library were searched for randomized controlled trials comparing tirzepatide versus placebo for individuals with overweight or obesity. Odds ratios (ORs) with 95% credible intervals (CrIs) were pooled using a Bayesian binomial-normal hierarchical model, appropriate for rare-event outcomes. RESULTS: Our meta-analysis included 10 randomized controlled trials, including 6515 individuals, of whom 4491 (68.9%) were randomized to tirzepatide. The pooled OR was 2.20 (95% CrI, 0.81-6.75) for atrial fibrillation, 2.16 (95% CrI, 0.90-5.87) for atrial arrhythmia, and 1.84 (95% CrI, 1.04-3.90) for any arrhythmia. CONCLUSIONS: Tirzepatide was not associated with atrial fibrillation or atrial arrhythmia. Although higher odds of overall arrhythmias were observed, event rates were low and the findings should be interpreted cautiously.
Cite This Study
Mansouri et al. (2026) conducted a meta-analysis in overweight or obesity (n=6,515). Tirzepatide vs. placebo was evaluated on atrial fibrillation (OR 2.20, 95% CI 0.81-6.75). Tirzepatide was not associated with an increased incidence of atrial fibrillation (OR 2.20; 95% CrI 0.81-6.75) compared to placebo in adults with overweight or obesity.