Arrhythmias & electrophysiology
Metformin as an Adjunctive Therapy to Catheter Ablation of Atrial Fibrillation (META-AF)
Authors' conclusion
In patients with AF, elevated BMI, and without diabetes, treatment with metformin may reduce recurrent atrial arrhythmias after ablation. These findings require confirmation in larger trials.
Study context
- Population
- Patients undergoing atrial fibrillation (AF) ablation with body mass index (BMI) > 25 kg/m² and without diabetes
- Participants
- 99 patients
- Comparison
- Metformin vs usual care before ablation
- metforminn = 49
- usual caren = 50reference
- Primary endpoint
- Freedom from recurrent atrial arrhythmia (3-month blanking period)
- Follow-up
- 12 months after ablation
Primary result
As reported in the abstract
Freedom from recurrent atrial arrhythmia (3-month blanking period)
Hazard ratio
0.5
95% CI 0.2–0.9
P = 0.04
Events by treatment group
Metformin vs usual care
HR 0.5 (95% CI 0.2–0.9); P = 0.04
Further findings
Antiarrhythmic drug use after ablation
Median
| Outcome | Metformin | Usual care | P value |
|---|---|---|---|
| AF burden · the year after ablation · lower in the metformin group | 0% (IQR 0%–0%) | 0% (IQR 0%–25%) | P = 0.03 |
Original publication
Metformin as an Adjunctive Therapy to Catheter Ablation of Atrial Fibrillation (META-AF). JACC Clin Electrophysiol. Published 15 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it