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

BACKGROUND: Current studies suggest a potential association between the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and atrial fibrillation (AF) recurrence after catheter ablation, but the findings remain controversial. Therefore, we conducted a meta-analysis to evaluate this association, aiming to provide evidence for clinical prevention and treatment. METHODS: We systematically searched PubMed, Embase, Web of Science, Cochrane Library, and four Chinese databases (CNKI, WanFang, VIP, and CBM) up to June 10, 2026, for studies on the association between GLP-1RAs and AF recurrence following catheter ablation. Two researchers independently screened literature, extracted data and assessed study quality. Statistical analyses were performed using Review Manager 5.3 and R 4.6.0. RESULTS: A total of seven studies involving 7,907 patients were included. The meta-analysis showed that the use of GLP-1RAs was associated with a reduced risk of AF recurrence after catheter ablation (HR = 0.52, 95%CI = 0.37-0.73, P < 0.001). Subgroup analyses consistently demonstrated a protective effect of GLP-1RAs on AF recurrence, irrespective of sample size (≤200: HR = 0.34, 95%CI = 0.22-0.52, P < 0.001 vs. > 200: HR = 0.70, 95%CI = 0.53-0.91, P = 0.009), study design (prospective: HR = 0.56, 95%CI = 0.43-0.72, P < 0.001 vs. retrospective: HR = 0.47, 95%CI = 0.25-0.89, P = 0.020), or follow-up duration (≤12 months: HR = 0.53, 95%CI = 0.40-0.72, P < 0.001 vs. > 12 months: HR = 0.58, 95%CI = 0.35-0.95, P = 0.030). CONCLUSIONS: The use of GLP-1RAs may reduce the risk of AF recurrence after catheter ablation. However, the 95% prediction interval crossed the null value, indicating that this protective effect is not definitive. Given the limitations of this study, further high-quality randomized controlled trials are warranted to confirm these findings.