JACC Clin Electrophysiol

GLP-1 drugs outperform bariatric surgery after afib ablation

March 23, 2026

In a propensity‑matched retrospective cohort of 2,466 adults with obesity undergoing afib ablation, investigators compared patients who initiated GLP‑1 receptor agonist therapy with those who underwent bariatric surgery afterward. Despite having more baseline comorbidities—including higher rates of diabetes, hypertension, heart failure, and chronic kidney disease—the GLP‑1 RA group demonstrated significantly better outcomes across multiple endpoints. At two years, bariatric surgery was associated with higher afib readmission (45.3% vs. 36.4%; hazard ratio [HR] 1.37; 95% confidence interval, 1.21–1.56), heart failure readmission (HR, 1.51), all‑cause readmission (HR, 1.55), and all‑cause mortality (HR, 2.53). No differences were seen in stroke, repeat ablation, or cardioversion.

Clinical takeaway: In obese patients referred for afib ablation, structured weight‑loss therapy should be part of pre‑ and post‑procedural management; GLP‑1 receptor agonists may be a reasonable alternative for patients who are not candidates for, or prefer to avoid, bariatric surgery.

Source:

Patel H, et al. (2026, March 16). JACC Clin Electrophysiol. Comparative Outcomes of GLP-1 Receptor Agonists vs Bariatric Surgery in Patients Undergoing Atrial Fibrillation Ablation. https://pubmed.ncbi.nlm.nih.gov/41649433/