New research out of the American Heart Association has put a focus on metformin, a drug usually used to control glucose. Metformin might help prevent Atrial Fibrillation, also known as AFib, from coming back in overweight or obese adults who don’t actually have diabetes.
The META-AF trial studied 99 adults with AFib and higher body weight (largely obese and some overweight) who all had just undergone a catheter ablation to reinstate a normal heartbeat. No one had type 2 diabetes. The researchers divided them into two groups: one received usual post-ablation care-in other words, advice about lifestyle, healthy eating, sleep, and management of comorbid conditions-and the other group received all the above plus metformin.
After a year, the difference was pretty clear. In the metformin group, 78% didn’t have any AFib episodes lasting 30 seconds or more. In the usual-care group, that number was 58%. Fewer people taking metformin needed a second ablation or a shock to the heart, 6% versus 16%, and fewer needed to stay on antiarrhythmic drugs, 8% versus 18%. And here’s the twist—both groups lost about the same amount of weight. So, the effect doesn’t look like it’s just about shedding pounds.
That’s a big deal, considering AFib is the most common long-lasting heart rhythm problem in the U.S., and extra weight makes it more likely to come back after ablation. That a medication generally used for metabolism may also have benefits on the heart rhythm highlights just how interrelated metabolic health and heart health really are.
Though, it is important to consider that this was a small study, only 99 people, all at one academic center, and everyone knew which treatment they were getting-there was no placebo group for comparison. In addition, it looked only at overweight or obese adults without diabetes, so we cannot say much about how it would work in other groups-such as people with diabetes, younger or older adults, or people from more diverse backgrounds. The researchers themselves say this isn’t a reason to change medical practice yet. For now, the basics still matter most: if you need to, lose weight; get regular exercise; improve your sleep; and keep other risk factors in check.
This study is just a look at what’s possible for medical innovation against AFib. At the moment, health-conscious individuals can focus on weight loss, fitness, blood pressure, and sleep. Ultimately, the META-AF study opens the door to metabolic drugs like metformin for heart rhythm problems in overweight people, but we’re not there yet. If bigger studies corroborate this study, it may be a novel and useful innovation to prevent AFib in people who struggle with heart rhythm and metabolic health.
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