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2025 AF Symposium
Weight Loss Drugs and A-Fib
Donna Ryan, MD
Dr. Donna Ryan of Louisiana State University, Baton Rouge, Louisiana gave a talk on GLP-1 Agonists and their role in treating A-Fib. “The Role of GLP-1 Agonists in Patients with Atrial Fibrillation.”
GLP-1 Agonists
GLP-1 agonists are medications (such as brand names Ozempic, Mounjaro and Victoza) used to treat type 2 diabetes and obesity. They work by mimicking the hormone GLP-1 which helps regulate blood sugar levels and promote satiety. They stimulate the pancreas to release insulin, slow down digestion, and reduce appetite.
GLP-1 agonists are not new. They were first developed over 20 years ago. Exenatide (Byetta) was first produced in the 1990s. (It was FDA approved in 2005.) Dr. Ryan pointed out that GLP-1 agonists may be a particularly good therapy, not just for weight loss but for other health problems as well.
GLP-1 Medications
Liraglutide (Victoza) in 2016 was the first GLP-1 to demonstrate cardiovascular risk reduction.
GLP-1 Agonist Medications
Semaglutide (Ozempic) in 2022 captured the public’s imagination because it produced an average 15% weight loss and it reduced major adverse cardiovascular events (MACE).
Tirzepatide (Mounjaro) in 2023 was found to produce a 23% average weight loss.
Dr. Ryan showed how GLP-1 agonists have other disease modifying properties besides weight loss [or perhaps because of weight loss] such as kidney disease, sleep apnea, major adverse cardiovascular events, etc.
How GLP-1 Agonists Work
GLP-1 agonists increase insulin, manage glycemia (glucose in the blood), help in losing weight, have powerful anti-inflammatory effects, lower blood pressure, decrease appetite, help the kidneys, and improve platelet coagulation.
GLP-1 Research and A-Fib Remission
Dr. Ryan discussed research from Dr. Prashanthan Sanders from Australia in which patients who bought into his weight loss and exercise program not only lost weight but in some cases lost their A-Fib [see my post: Pre-Ablation Fitness Prevents Recurrence of Atrial Fibrillation]. But she acknowledged that it’s often difficult to achieve weight loss in routine medical practice.
How Obesity Impacts a Patient’s A-Fib
She also talked about how obesity impacts a patient’s A-Fib and is the second biggest risk factor (after hypertension) for developing and staying in A-Fib. According to Dr. Ryan obesity in A-Fib patients:
• increases the incidence of A-Fib
• expands the rate of progression
• increases the severity of A-Fib symptoms
• decreases the success of rhythm control strategies
• and increases the risk of worse outcomes
Editor’s Comments
Many A-Fib patients are overweight and also suffer from sleep apnea and hypertension.
Dr. Ryan’s presentation offers insight into how today’s GLP-1 agonists may go beyond helping with weight loss. A GLP-1 can also help improve sleep apnea and/or high blood pressure.
What A-Fib Patients Should Know: If you are carrying extra weight, talk to your cardiologist and your family doctor about using a GLP-1. If you also have sleep apnea and/or high blood pressure, a GLP-1 may help you improve your cardiac health and these other ailments.
