Arrhythmias & electrophysiology

The Effect of Glucagon-Like Peptide-1 Receptor Agonists versus Sodium-Glucose Cotransporter-2 Inhibitors Alone and in Combination on Atrial Fibrillation (AF) Recurrence and Cardiovascular Outcomes after Catheter Ablation for Atrial Fibrillation

Heart RhythmPublished Propensity score matching (PSM) analysis of the TriNetX database

Authors' conclusion

GLP-1 RA and SGLT2i alone or in combination were associated with comparable AF recurrence rates following CA for AF. However, combination therapy was consistently associated with lower all-cause mortality.

Study context

Population
Adults with AF who underwent catheter ablation (CA) for AF, TriNetX database (2018–2024)GLP-1 RA vs SGLT2i (each) 1,393 · combination vs GLP-1 RA (each) 952 · combination vs SGLT2i (each) 1,213
Exposure
GLP-1 RA vs SGLT2i, combination vs GLP-1 RA, and combination vs SGLT2i
Outcome
AF recurrence, defined as repeat CA, cardioversion, or antiarrhythmic drug use after a 3-month blanking period

Main finding

As reported in the abstract

AF recurrence, defined as repeat CA, cardioversion, or antiarrhythmic drug use after a 3-month blanking period
Hazard ratio (95% CI)P value
GLP-1 RA vs SGLT2in=1,393 each
1.01(0.89–1.15)
P = 0.86
Combination vs GLP-1 RAn=952 each
1.13(0.98–1.31)
P = 0.10
Combination vs SGLT2in=1,213 each
1.09(0.96–1.24)
P = 0.20

Observational data: associations, not effects.

Secondary outcomes

OutcomeHR (95% CI)P value
All-cause mortality — combination vs GLP-1 RA · lower in the combination group0.54 (0.34–0.87)P = 0.01
All-cause mortality — combination vs SGLT2i · reduced0.60 (0.39–0.93)P = 0.02

Secondary outcomes, including stroke, heart failure, and all-cause hospitalization

Similar among all three groups

Original publication

The Effect of Glucagon-Like Peptide-1 Receptor Agonists versus Sodium-Glucose Cotransporter-2 Inhibitors Alone and in Combination on AF Recurrence and Cardiovascular Outcomes after Catheter Ablation for Atrial Fibrillation. Heart Rhythm. Published 17 September 2026. doi:10.1016/j.hrthm.2026.09.018

Summarised from the published abstract; every number is checked against it

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