Effect of Semaglutide on Atrial Arrhythmias Recurrence Following Ablation for Atrial Fibrillation: A Prospective Study

BACKGROUND: Recurrence of atrial arrhythmias remains a significant challenge following catheter ablation for atrial fibrillation. The potential role of semaglutide in reducing atrial arrhythmia recurrence postablation is unclear. METHODS: A consecutive sample of 437 patients with a body mass index ≥24 kg/m² and type 2 diabetes who underwent their first atrial fibrillation ablation procedure between January 2022 and March 2024 were enrolled. Participants were divided into a semaglutide group and a control group based on patient preference. The primary outcome was the freedom from atrial arrhythmia recurrence during the 12-month follow-up period after the 3-month blanking period postablation. RESULTS: Of the 437 enrolled patients, 158 opted for semaglutide therapy and 279 declined. At baseline, the semaglutide group had higher body mass index (27.5 2.2 versus 27.0 2.4; P =0.038) and glycated hemoglobin levels (8.0 1.0 versus 7.6 1.1; P <0.001) compared with controls. During the 12-month follow-up, the semaglutide group showed a higher event-free rate for recurrent atrial arrhythmias (hazard ratio, 0.68 95% CI, 0.49–0.95; P =0.030), greater weight loss (−8.2% 3.2 versus −4.6% 2.9; P <0.001), and larger reductions in glycated hemoglobin (−1.3% 0.8 versus −0.6% 0.8; P <0.001). CONCLUSIONS: Semaglutide treatment following catheter ablation for atrial fibrillation is associated with a lower rate of atrial arrhythmia recurrence over 12 months and may lead to improvements in weight and glycated hemoglobin levels.