Effect of Semaglutide on Atrial Arrhythmias Recurrence Following Ablation for Atrial Fibrillation: A Prospective Study.

BACKGROUND: Recurrence of atrial arrhythmias remains a significant challenge following catheter ablation for atrial fibrillation. The potential role of semaglutide in reducing atrial arrhythmia recurrence postablation is unclear. METHODS: A consecutive sample of 437 patients with a body mass index ≥24 kg/m² and type 2 diabetes who underwent their first atrial fibrillation ablation procedure between January 2022 and March 2024 were enrolled. Participants were divided into a semaglutide group and a control group based on patient preference. The primary outcome was the freedom from atrial arrhythmia recurrence during the 12-month follow-up period after the 3-month blanking period postablation. RESULTS: Of the 437 enrolled patients, 158 opted for semaglutide therapy and 279 declined. At baseline, the semaglutide group had higher body mass index (27.5 [2.2] versus 27.0 [2.4]; =0.038) and glycated hemoglobin levels (8.0 [1.0] versus 7.6 [1.1]; <0.001) compared with controls. During the 12-month follow-up, the semaglutide group showed a higher event-free rate for recurrent atrial arrhythmias (hazard ratio, 0.68 [95% CI, 0.49-0.95]; =0.030), greater weight loss (-8.2% [3.2] versus -4.6% [2.9]; <0.001), and larger reductions in glycated hemoglobin (-1.3% [0.8] versus -0.6% [0.8]; <0.001). CONCLUSIONS: Semaglutide treatment following catheter ablation for atrial fibrillation is associated with a lower rate of atrial arrhythmia recurrence over 12 months and may lead to improvements in weight and glycated hemoglobin levels.