TOPLINE

In adults with overweight or obesity, tirzepatide was not associated with increased odds of atrial fibrillation (AF) or atrial arrhythmia. Higher odds of any arrhythmia were observed, although event rates remained low and the evidence was not conclusive.

METHODOLOGY

• Researchers conducted an updated systematic review and meta-analysis of randomized controlled trials to assess whether tirzepatide was associated with the incidence of AF and other arrhythmias in adults with overweight or obesity.
• They searched multiple databases and references through June 2026 and included 10 trials with 6515 patients (mean age, 51 years; 53% women) for the final analysis.
• Overall, 68.9% of patients were randomly assigned to receive tirzepatide and 31.1% were randomly assigned to receive placebo.
• The outcomes included the incidence of AF, atrial arrhythmia, and any arrhythmia. Follow-up duration was mostly between 40-72 weeks.
• Researchers evaluated risk for bias and quality of evidence.

TAKEAWAY

• Tirzepatide was not associated with higher odds of AF (four studies) or atrial arrhythmia (seven studies) compared with placebo.
• Tirzepatide was associated with higher odds of any arrhythmia (10 studies; pooled odds ratio, 1.84; 95% credible interval, 1.04-3.90). However, the event rates were low.
• Heterogeneity across trials was low, and researchers rated the certainty of evidence for AF and overall arrhythmias as moderate. Risk for bias was judged low in six trials and four had some concerns.

IN PRACTICE

"Although no clear association with AF or atrial arrhythmia was observed, the effect estimates for any arrhythmias suggested higher odds with tirzepatide. Because arrhythmias were not prespecified endpoints in most trials and event counts were low, these findings should be considered exploratory," the researchers wrote.

SOURCE

The study was led by Ensieh S. Mansouri, MD, of Tehran University of Medical Sciences in Tehran, Iran. It was published online on September 9 in the Journal of the American Heart Association.

LIMITATIONS

Arrhythmia events were usually reported as adverse events and were not captured as planned study endpoints. Major predictors of AF were not reported systematically. The small number of events may have introduced uncertainty.

DISCLOSURES

The study did not receive any specific funding. The authors reported having no conflicts of interest. One author reported receiving financial compensation for teaching methods of systematic review and meta-analysis.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.