AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
GLP-1 Receptor Agonists and Outcomes After Atrial Fibrillation Ablation: A Systematic Review and Meta-Analysis
By PULLITHODIKA MN, Shah I, Puthia Valappil OM et al.
Introduction Catheter ablation represents an established and effective rhythm control strategy for atrial fibrillation (AF); however, post-ablation AF recurrence continues to pose a significant clinical challenge, largely attributable to underlying metabolic and structural risk factors. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have garnered considerable attention for their broader cardiovascular benefits, yet their potential role in mitigating AF recurrence following ablation remains insufficiently characterized. This meta-analysis sought to systematically evaluate the efficacy and safety of GLP-1 RAs in patients undergoing catheter ablation for AF. Research Question In patients undergoing catheter ablation for AF, do treatment with GLP-1 RAs reduce recurrence, improve rhythm control and clinical outcomes compared with standard care or no therapy? Methods We searched PubMed/MEDLINE, Cochrane Central Library, ScienceDirect, Google Scholar, and ClinicalTrials.gov from inception through 2026 for randomized controlled trials, clinical trials, and observational studies enrolling adults (≥18 years) who underwent catheter ablation for AF and received GLP-1 RAs versus placebo, standard care, or active comparator. Primary outcome was post-ablation AF recurrence; secondary outcomes included composite rhythm control intervention (cardioversion, repeat ablation, or new AAD initiation), HF hospitalization and all-cause mortality. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using random-effects models. Results Four studies (4 cohorts; n=16,135) were included. GLP-1 RAs significantly reduced AF recurrence (HR 0.70 95% CI [0.55-0.88], P=0.003). GLP-1 RA use was associated with a nonsignificant reduction in the risk of composite rhythm-control intervention compared with standard care (HR 0.89, 95% CI [0.74-1.06; p=0.19). GLP-1 RA use significantly reduced risks of HF hospitalization (HR 0.86, 95% CI [0.80-0.92]; p<0.0001) and all-cause mortality (HR 0.74, 95% CI [0.56-0.97]; p=0.03) compared with standard care. Conclusion GLP-1 receptor agonists reduce post-ablation AF recurrence, HF hospitalizations, and all-cause mortality, suggesting a clinically meaningful adjunctive role for these agents in post-ablation management, particularly in patients with obesity, diabetes, or heart failure. However, the predominance of observational data limits causal inference, and adequately powered randomized controlled trials are urgently needed to establish definitive treatment recommendations.