Atrial fibrillation (AF) is the most common persistent arrhythmia and demonstrates a notable recurrence rate after ablation. Previous studies have suggested that surrogate markers of insulin resistance could predict postablation AF recurrence. This systematic review and meta-analysis aimed to assess studies examining the relationship between surrogate insulin resistance markers and the recurrence of AF after ablation. We searched PubMed, Web of Science, Embase, and Scopus for observational studies published from inception to August 2024. We incorporated studies that assessed the relationship between surrogate insulin resistance markers and the occurrence of postablation AF in patients with either paroxysmal or persistent AF. The random-effects model was used for meta-analysis. The Newcastle-Ottawa scale was used to evaluate risk of bias, and the leave-one-out method was applied for sensitivity analysis (PROSPERO: CRD42024584526). Nine studies involving 7729 participants met the inclusion criteria. Significant associations with AF recurrence were observed for the triglyceride-glucose index (hazard ratio [HR] 1.29
95% confidence interval [CI] 1.15-1.44
I