Tirzepatide on Atrial Fibrillation Recurrence After Catheter Ablation in Patients With Obesity and HFpEF

Inclusion Criteria: * Age 18 to 80 years * Symptomatic atrial fibrillation (paroxysmal or persistent of ≤ 5 years duration), undergoing first-time catheter ablation * Body weight criteria (aligned with NMPA-approved tirzepatide indication)，meeting at least one of the following: * BMI ≥28.0 kg/m² (obesity threshold per Chinese criteria), OR * BMI ≥24.0 kg/m² and \<28.0 kg/m² (overweight per Chinese criteria) with at least one weight-related comorbidity: hypertension, dyslipidemia, type 2 diabetes mellitus (T2DM), obstructive sleep apnea syndrome (OSAS), or atherosclerotic cardiovascular disease (ASCVD) * HFpEF defined by intraprocedural mean left atrial pressure ≥ 15 mmHg at rest * Left ventricular ejection fraction ≥ 50% on echocardiography within 30 days prior to enrollment * Provision of written informed consent Exclusion Criteria: * Prior use of any GLP-1 receptor agonist or GIP/GLP-1 dual receptor agonist * Type 1 diabetes mellitus; or type 2 diabetes with HbA1c \> 10% * Personal history of pancreatitis; personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN2) * Severe gastrointestinal disease, including gastroparesis or active inflammatory bowel disease * Prior bariatric surgery * Moderate or severe valvular heart disease, hypertrophic cardiomyopathy, cardiac amyloidosis, constrictive pericarditis, or restrictive cardiomyopathy * Severe renal impairment (eGFR \< 30 mL/min/1.73m²) * Active malignancy, excluding basal cell carcinoma * Acute coronary syndrome, stroke, percutaneous coronary intervention, or cardiac surgery within 30 days prior to enrollment * Pregnancy, lactation, or planned pregnancy within 6 months * Life expectancy \< 12 months * Concurrent participation in another interventional clinical trial * Any condition that, in the investigator's judgment, would interfere with participation