Arrhythmias & electrophysiologyCohort study
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
- 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
Hazard ratio (95% CI)P value
GLP-1 RA vs SGLT2in=1,393 each
1.01(0.89–1.15)
P = 0.86combination vs GLP-1 RAn=952 each
1.13(0.98–1.31)
P = 0.10combination vs SGLT2in=1,213 each
1.09(0.96–1.24)
P = 0.20Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality — combination vs GLP-1 RA · lower in the combination group | 0.54 (0.34–0.87) | P = 0.01 | |
| All-cause mortality — combination vs SGLT2i · reduced | 0.60 (0.39–0.93) | P = 0.02 | |
| 0.20.5125Hazard ratio (log scale) |
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