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Updated: May 21, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

The Liraglutide Effects in Atrial Fibrillation (LEAF) Study.

Jeffrey J Goldberger¹, Raul D Mitrani¹, Joel Fishman²

¹Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.

JACC. Clinical Electrophysiology

|May 20, 2026

Summary

Adding liraglutide to risk factor modification (RFM) improved freedom from atrial fibrillation (AF) after ablation, despite no significant early differences in weight loss or epicardial adipose tissue (EAT) reduction. This suggests potential new pharmacologic targets for AF treatment.

Keywords:

GLP-1 receptor agonists atrial fibrillation catheter ablation epicardial adipose tissue obesity

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Area of Science:

Cardiology
Endocrinology
Pharmacology

Background:

Atrial fibrillation (AF) ablation outcomes are suboptimal, especially for persistent AF.
Obesity and epicardial adipose tissue (EAT) negatively impact AF and ablation success.
Risk factor modification (RFM), including weight loss, enhances AF treatment efficacy.

Purpose of the Study:

To evaluate the efficacy of liraglutide as an adjunctive therapy in patients with AF undergoing catheter ablation.
To assess the impact of liraglutide on epicardial adipose tissue (EAT) and AF recurrence.

Main Methods:

Randomized study involving overweight/obese patients with AF undergoing catheter ablation.
Patients received either RFM alone or RFM plus liraglutide (RFM+L) for 3 months preablation.
Epicardial adipose tissue (EAT) volume, total EAT, and AF recurrence at 1 year were assessed.

Main Results:

Liraglutide therapy did not significantly alter early weight loss or left atrial epicardial adipose tissue (LAEAT) reduction compared to RFM alone.
One-year freedom from AF/atrial flutter was significantly higher in the RFM+L group (81%) versus the RFM group (54%).
RFM+L was associated with a reduced risk of 12-month AF recurrence, with changes in EAT density also correlating with lower recurrence rates.

Conclusions:

Adjunctive liraglutide therapy to RFM in obese AF patients improved freedom from AF/atrial flutter post-ablation.
Glucagon-like peptide-1 receptor agonist pleiotropic effects may offer novel therapeutic strategies for AF.
Liraglutide holds promise for substantially improving AF ablation outcomes, warranting further investigation.