Arrhythmias & electrophysiologyRandomised controlled trial
Metformin as an Adjunctive Therapy to Catheter Ablation of Atrial Fibrillation (META-AF)
- single-center, randomized, open-label trial
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
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:10.1016/j.jacep.2026.07.008
Summarised from the published abstract; every number is checked against it