Effect of GLP-1 receptor agonists on post-ablation atrial fibrillation recurrence: A meta‑analysis

Authors

• Abdalhakim Shubietah, Advocate Health - MidwestFollow
• Mohamed S. Elgendy, Faculty of Medicine, Tanta University, Tanta, Egypt.
• Ameer Awashra, Department of Medicine, An-Najah National University, Nablus, Palestine.
• Mohamed R. Murad, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
• Mohammad Alqudah, Faculty of Medicine, Yarmouk University, Irbid, Jordan.
• Ibrahim Gowaily, Department of Medicine, Creighton University School of Medicine, Omaha, Nebraska, USA.
• Ahmed Almahdy Mohamed, Department of Cardiology, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA.
• Ahmed Emara, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
• Emmanuel Olumuyide, Advocate Health - MidwestFollow
• Ahmed Elbataa, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
• Mohamed Abuelazm, Faculty of Medicine, Tanta University, Tanta, Egypt.
• Mohammed Mhanna, Division of Cardiovascular Medicine, University of Iowa, Iowa City, Iowa, USA.

Recommended Citation

Shubietah A, Elgendy MS, Awashra A, et al. Effect of GLP-1 Receptor Agonists on Post-Ablation Atrial Fibrillation Recurrence: A Meta‑Analysis. Pacing Clin Electrophysiol. Published online April 25, 2026. doi:10.1111/pace.70262

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background: Among patients undergoing catheter ablation for atrial fibrillation (AF), it remains uncertain whether peri- or post-ablation use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduces AF recurrence.

Objectives: We conducted a meta-analysis of observational studies and randomized controlled trials comparing GLP-1 RA therapy versus no GLP-1 RA use on AF recurrence following ablation.

Methods: We systematically searched PubMed, Scopus, Web of Science, and Embase for adult randomized and observational studies. Random-effects models generated risk ratios (RRs), and heterogeneity was assessed via I². Time-to-event outcomes were synthesized using reconstructed individual patient data from Kaplan-Meier curves.

Results: Six studies met the inclusion criteria, with four contributing data for Kaplan-Meier curve reconstruction and five included in the hazard ratio (HR) meta-analysis. Across four studies (n = 695; GLP-1 RA = 295; control = 400), pooled Kaplan-Meier curves showed a lower risk of AF recurrence with GLP-1 RA therapy (HR 0.53, 95% confidence interval [CI]: 0.38-0.72), with a restricted mean survival time (RMST) advantage of 1.02 months. A random-effects meta-analysis of five studies confirmed this benefit (HR 0.78, 95% CI: 0.61-0.99; I² = 75%). Pairwise analyses at 12 months demonstrated fewer AF recurrences with GLP-1 RAs (28.6% vs. 32.9%; RR 0.82, 95% CI: 0.76-0.90; I² = 46.9%).

Conclusion: GLP-1 RA therapy was associated with reduced AF recurrence after ablation, but methodological limitations warrant cautious interpretation. Prospective randomized trials are needed to confirm this potential benefit.

Type

Article

PubMed ID

42033283