Abstract 4368871: Impact of Glucagon-Like Peptide-1 Agonists on Ventricular Tachycardia Ablation Outcomes: a Matched Analysis

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RA) have been shown to reduce major cardiac events. However, their impact on ventricular tachycardia (VT) catheter ablation outcomes is not well studied. Aims: To examine the impact of GLP-1 RA use on VT ablation outcomes. Methods: Using the TriNetX research network we identified, by means of Current Procedural Terminology codes, patients ≥18 years of age who had undergone VT ablation between 2010 and 2024. Patients undergoing premature ventricular ablation were excluded. Patients were stratified based on the baseline GLP-1 RA use at the time of index procedure. The primary outcome was in-hospital mortality. Secondary outcomes were VT recurrence, repeat ablation, cardiac tamponade and need for blood transfusion. Results: Propensity-score matching resulted in 584 patients in each cohort. The mean age was 63 ± 810 years and 70% were males. GLP-1 RA use was associated with a significantly lower risk of in-hospital mortality (HR 0.51; 95% CI 0.38–0.67; p = 0.005), VT recurrence (HR 0.82; 95% CI 0.69–0.96; p = 0.04), repeat ablation (HR 0.627; 95% CI 0.40–0.96; p = 0.031), and need for blood transfusion (HR 0.45; 95% CI 0.28–0.71; p < 0.001). No significant difference was observed in the risk of cardiac tamponade (HR 0.753; 95% CI 0.17–3.37; p = 0.39). Conclusion: In this large, real-world cohort of patients undergoing catheter ablation for VT, baseline use of GLP-1 RA use was independently associated with lower risks of mortality, arrhythmia recurrence, repeat ablation, and transfusions. No significant difference was observed in procedural complication rates. These findings generate hypothesis-supporting evidence for a potential protective role of GLP-1 RAs in the VT ablation population and highlight the need for prospective studies to validate their mechanistic and therapeutic impact on ventricular arrythmias.