Arrhythmias & electrophysiologyRandomised controlled trial
The Liraglutide Effects in Atrial Fibrillation (LEAF) Study
- randomized study
Authors' conclusion
Whereas adding liraglutide to RFM in obese patients with AF did not produce significant differences in early weight loss or LAEAT reduction, improved freedom from AF/atrial flutter was noted. Pleiotropic glucagon-like peptide-1 receptor agonist effects may provide novel pharmacologic targets for AF treatment that can substantially improve AF ablation outcomes. (Liraglutide Effect in Atrial Fibrillation [LEAF]; NCT03856632).
Study context
- Population
- Overweight/obese (body mass index ≥27 kg/m²) patients with atrial fibrillation (AF) (80% persistent AF) who opted for catheter ablationRisk factor modification (RFM) 28 · RFM+L 31
- Participants
- 31 vs 28
- Comparison
- RFM+L vs RFM for 3 months preablation
- RFM+Ln = 31
- RFMn = 28reference
- Primary endpoint
- Change in left atrial epicardial adipose tissue (LAEAT) volume
- Follow-up
- Preablation
Primary result
As reported in the abstract
Overall reduction in left atrial epicardial adipose tissue (LAEAT), median
−1.0 [Q1-Q3: −4.5 to 1.4] mL; P = 0.02
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| 12-month recurrence (logistic regression) · LAEAT model | 0.19 (0.05–0.73) | P = 0.015 | |
| 12-month recurrence (logistic regression) · EAT model | 0.08 (0.01–0.40) | P = 0.002 | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | RFM+L | RFM | Estimate | P value |
|---|---|---|---|---|
| Freedom from AF/atrial flutter · 1 year | 81% (95% CI 62%–91%) | 54% (95% CI 34%–70%) | ||
| Patients not proceeding with ablation | 3 events | One events |
- Freedom from AF/atrial flutter: log-rank P = 0.007
- Patients not proceeding with ablation: "preablation" testing was performed at the time of this decision
Weight · preablation
- Overall weight change
- −2.8 ± 4.0 kg; P < 0.001
- No difference between groups
Change in epicardial adipose tissue (EAT) density and recurrence
- Change in EAT density associated with lower recurrence, OR
- 0.55; 95% CI: 0.36-0.84; P = 0.006
Original publication
Summarised from the published abstract; every number is checked against it