Weight Loss Drugs, Wegovy / Zepbound, & AFib

By now, you have undoubtedly heard of or maybe even considering the so-called “miracle” weight loss drugs – Wegovy & Zepbound – used in patients with obesity and/or cardiovascular disease. These drugs are known as GLP-1 agonists since they stimulate hormone production that induces satiety and, ultimately, weight loss. The results can be very effective with weight loss of up to 15% of total body weight for Wegovy and 20% for Zepbound. But how does this help someone with Atrial fibrillation (AFib)? Let’s dig a little deeper.

• Weight Loss: While there are many causes of AFib, excess weight and obesity are significant risks. Of course, we want patients to lose weight through traditional diet and exercise, but many are not able to do so, and these medication can be very helpful.
• These drugs have also shown improvements in the risk associated with severe cardiovascular events like heart attack and stroke. This is again due to the rapid weight loss many patients experience and potential for anti-inflammatory properties.
• Lastly, more recent studies have shown that these drugs may be effective in the fight against obstructive sleep apnea. OSA is a significant risk factor in the development and worsening of atrial fibrillation.

Is This a Miracle Drug for AFib?

Unfortunately, while the headlines may show some sensational results, there is plenty that we need to consider before looking to GLP-1 agonists as the answer to cardiovascular disease and AFib in particular. One, drugs only work for as long as they are taken. In other words, most patients will regain their weight, possibly even more than they lost, after they stop taking medication. Further, we don’t know the side effect profile or insurance coverage of these medications taken over the long term. As such, they should only be considered a short to medium-term option for most patients.

Second, the weight loss numbers in the news and social media apply only to approximately the top-third of patients. In other words, about 60% of patients will not achieve those maximum results. In some cases, the drug does not work at all, and those patients do not experience any weight loss and associated benefits.

It’s also not guaranteed that losing weight will eliminate AFib. Plenty of people with an average BMI have Afib, and others with obesity do not. Further, the longer you have had AFib, the more difficult it will be to treat. AFib ablation has a higher success rate the sooner it is performed. But nevertheless, weight loss has been showed to improve chances of ablation success as well. Ultimately, your heart is unique, and visiting an electrophysiologist to understand more about your condition is always the first and best option.

We would be remiss not to discuss the potential side effects of these drugs. Patients have reported everything from mild gastrointestinal upset up to persistent nausea, vomiting, and even gallbladder disease, pancreatitis, and gastroparesis (stomach paralysis). Some of these are serious enough that the drugs need to be stopped.

Ultimately, there is a narrow band of patients that will have transformative weight loss and disease resolution by using weight loss medication. However, this is not a reason to delay care for an arrhythmia such as Afib. Patients should visit a qualified electrophysiologist like Dr. Osorio to understand more about their various treatment options, including minimally invasive catheter-based procedures. Evaluating every option is the best way to make an informed decision.

Procedures and medication working symbiotically.

Because of the incredible advancements in technology and weight loss medications, we can now combine more than one therapy to offer patients the best chance of success. If the patient is a candidate, combining weight loss medications with a potentially curative procedure like an ablation can be an excellent way to address AFib. Speak to Dr. Osorio about any rhythm issues you may have noticed so they can be diagnosed and treated quickly.

The Bottom Line

We are excited by the exceptional technological advancements in atrial fibrillation treatment, including pulsed field ablation. This new non-thermal catheter-based procedure allows us to accurately target the areas in the heart that trigger AFib, with fewer risks and much more efficiently.

If you have the sensation of a pounding chest, fast heart, or any other symptom that may suggest atrial fibrillation or a cardiac arrhythmia, we encourage you to schedule a consultation. Be mindful that heart attacks share some of the same symptoms of AFib, and as such, if you believe you are having an emergency, do not delay in dialing 911 or getting to the nearest emergency room.

Dr Jose Osorio
Miami, FL

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Atrial Fibrillation Treatment Options

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