Effect of GLP-1 Receptor Agonists on Post-Ablation Atrial Fibrillation Recurrence: A Meta‑Analysis

Area of Science:

• Cardiology
• Metabolic Diseases
• Pharmacology

Background:

• Atrial fibrillation (AF) recurrence post-catheter ablation remains a clinical challenge.
• The role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in mitigating AF recurrence after ablation is not well-established.

Purpose of the Study:

• To evaluate the efficacy of GLP-1 RA therapy in reducing AF recurrence following catheter ablation.
• This meta-analysis synthesized data from observational studies and randomized controlled trials.

Main Methods:

• Systematic literature search across major databases (PubMed, Scopus, Web of Science, Embase).
• Inclusion of adult studies comparing GLP-1 RA use versus no GLP-1 RA use.
• Random-effects models for meta-analysis and reconstruction of individual patient data from Kaplan-Meier curves for time-to-event outcomes.

Main Results:

• Six studies were included, with data from 695 patients (295 on GLP-1 RAs).
• Pooled analysis indicated a reduced risk of AF recurrence with GLP-1 RA therapy (HR 0.53, 95% CI: 0.38-0.72) and a 1.02-month RMST advantage.
• Meta-analysis confirmed the benefit (HR 0.78, 95% CI: 0.61-0.99), with fewer recurrences at 12 months (28.6% vs. 32.9%).

Conclusions:

• GLP-1 RA therapy shows a potential association with reduced AF recurrence post-ablation.
• Methodological limitations necessitate cautious interpretation of current findings.
• High-quality prospective randomized trials are required to definitively establish the benefit of GLP-1 RAs in this context.