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Updated: Jan 7, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Impact of GLP-1 Receptor Agonist Therapy on Atrial Fibrillation Recurrence After Catheter Ablation in Obese Patients:
Sandrine Venier1,2, Pascal Defaye1,2, Lisa Lochon3
1Department of Cardiology, Grenoble Alpes University Hospital, Grenoble, France (S.V., P.D., R.B., A.C., Y.D., P.J.).
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.
Insights
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) significantly reduced atrial fibrillation recurrence after ablation in obese patients. GLP-1RA use also lowered risks of disease progression, cardiovascular hospitalizations, and mortality in this population.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established treatments for type 2 diabetes with known cardiometabolic benefits.
- Emerging evidence suggests GLP-1RAs may possess anti-arrhythmic properties, potentially by influencing atrial substrate and autonomic tone.
- The efficacy of GLP-1RAs in reducing atrial fibrillation (AF) recurrence post-ablation in obese, nondiabetic individuals is not well-established.
Purpose of the Study:
- To investigate the association between GLP-1RA use and the recurrence of atrial fibrillation (AF) in obese patients following catheter ablation.
- To evaluate the impact of GLP-1RA therapy on the progression to permanent AF, cardiovascular hospitalizations, and all-cause mortality in this patient cohort.
Main Methods:
- A retrospective cohort study utilizing the TriNetX research network, encompassing over 100 million de-identified electronic health records.
- Inclusion criteria: adult patients (≥18 years) with obesity (BMI >30 kg/m²) who underwent AF ablation between January 2015 and January 2025.
- Propensity score matching (1:1) was employed to create comparable cohorts of GLP-1RA users (n=3350) and nonusers (n=3350) based on 82 clinical and demographic variables.
Main Results:
- GLP-1RA users exhibited a significantly lower rate of AF recurrence compared to nonusers (6.66% vs. 7.72%; HR, 0.82; P<0.0001) over a median 2-year follow-up.
- Progression to permanent AF was less frequent in the GLP-1RA group (3.16% vs. 3.38%; HR, 0.77; P=0.01).
- GLP-1RA therapy was associated with reduced risks of all-cause mortality (HR, 0.73; P=0.01), heart failure hospitalizations (HR, 0.80; P<0.0001), and cardiovascular hospitalizations (HR, 0.85; P=0.001).
Conclusions:
- In obese patients undergoing AF ablation, GLP-1RA therapy is linked to a decreased risk of AF recurrence.
- GLP-1RA use demonstrated benefits in reducing the progression to permanent AF, cardiovascular hospitalizations, and overall mortality.
- These findings highlight the potential cardiometabolic and anti-arrhythmic advantages of GLP-1RAs in obese individuals post-AF ablation.
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