Diabetology & Metabolic Syndrome · Aug 10, 2026

Association of glucagon-like peptide-1 receptor agonist therapy with atrial fibrillation recurrence after catheter ablation: a systematic review and meta-analysis

By Shekouh D, Askarinejad A, Zangeneh S et al.

BACKGROUND: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide, with a rising global prevalence. Post-ablation AF recurrence remains frequent, particularly among patients with obesity and metabolic syndrome. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated favorable cardiometabolic and cardiovascular effects, but their association with AF recurrence after ablation remains uncertain. METHODS: PubMed, Scopus, Embase, and Web of Science were searched through June 18, 2026. Cohort studies evaluating GLP-1RA therapy in adults with atrial fibrillation undergoing catheter ablation were included. The primary outcome was post-ablation atrial fibrillation recurrence (or recurrent atrial tachyarrhythmia, as defined by the individual studies). Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Risk of bias was assessed using the JBI tool, and certainty of evidence was evaluated using the GRADE approach. RESULTS: Six cohort studies (three prospective and three retrospective), comprising 14,278 patients (7,065 GLP-1RA users and 7,213 controls), met the inclusion criteria. Follow-up duration ranged from 12 to 24 months across studies. The pooled mean age was approximately 64 years in both the GLP-1RA and control groups. GLP-1RA therapy was associated with a lower hazard of AF recurrence compared with the respective comparator groups (HR = 0.74, 95% CI 0.63-0.87; I² = 50.5%). However, the certainty of the evidence was low because the findings were derived predominantly from observational studies. CONCLUSIONS: Observational evidence suggests that GLP-1RA use is associated with a lower hazard of AF recurrence following catheter ablation. However, these findings should be interpreted cautiously, and further high-quality randomized controlled trials are required to confirm this association.

doi.org/10.1186/s13098-026-02268-z Open access PubMed 42989385 Interventions