Effects of Glucagon-Like Peptide-1 Receptor Agonists on Atrial Fibrillation Recurrence After Catheter Ablation

Abstract

Background: Relationship between glucagon-like peptide-1 receptor agonist (GLP-1 RA) use prior to atrial fibrillation (AF) ablation and subsequent AF recurrence is not well-understood.

Objectives: This study investigated the effects of GLP-1 RA use within 1 year before ablation and its association with AF recurrence and associated outcomes.

Methods: The TriNetX research database was used to identify patients aged ≥18 years undergoing AF ablation (2014-2023). Patients were categorized into 2 groups, and propensity score matching (1:1) between preablation GLP-1 RA users and nonusers was performed based on demographics, comorbidities, body mass index, laboratory tests, AF subtype, and medications. Primary outcome was composite of cardioversion, new antiarrhythmic drug therapy, or repeat AF ablation after a 3-month blanking period following the index ablation. Additional outcomes included ischemic stroke, all-cause hospitalization, and mortality during 12-month follow-up period.

Results: After 1:1 propensity score matching, the study cohort comprised 1,625 GLP-1 RA users and 1,625 matched GLP-1 RA nonusers. Preablation GLP-1 RA therapy was not associated with a lower risk of cardioversion, new AAD therapy, and repeat AF ablation after the index procedure (HR: 1.04 [95% CI: 0.92-1.19]; log-rank P = 0.51). Furthermore, the risk of ischemic stroke, all-cause hospitalization, and mortality during the 12-month follow-up period did not differ between the 2 groups.

Conclusions: These findings suggest that preprocedural use of GLP-1 RAs is not associated with a reduced risk of AF recurrence or associated adverse outcomes following ablation, and underscore the need for future research to determine whether these agents improve outcome in AF patients.

Keywords: GLP-1 receptor agonists; atrial fibrillation; catheter ablation.