Cognitive Dysfunction Risk After Ablation For AF

Patients with atrial fibrillation have increased risk for cognitive dysfunction. Whether or not catheter ablation for atrial fibrillation treatment ameliorates this cognitive dysfunction is unknown. Thus, Pengfei Chen and collaborating researchers examined cognitive outcomes and found that ablation showed a positive trend with improved cognitive function at 3 or more months postprocedure. No link was established between ablation and improvements before 3 months.

This systematic review and meta-analysis, published in Frontiers in Neurology, enrolled 13 studies published by September 2021 with 40,868 total patients. The researchers used a random-effects model to calculate differences between patients with atrial fibrillation and catheter ablation and patients with atrial fibrillation without catheter ablation. The primary end points of the analyses were dementia or cognitive disorder per scoring or established criteria.

Ablation Appears to Reduce Cognitive Risk in AF

Reportedly, patients with ablation had a reduced risk for dementia compared with patients without ablation (hazard ratio [HR], 0.60; 95% CI, 0.43-0.84; P=.003; I2=40%) as well as significantly reduced risk for new-onset dementia (risk ratio [RR], 0.43; 95% CI, 0.28-0.65; P<.0001; I2=84%).

The researchers found that ablation was associated with improvements in Montreal Cognitive Assessment (MoCA) score (weighted mean difference [WMD], 1.00; 95% CI, 0.36-1.64; P<.0005; I2=0%) and Mini-Mental State Examination score (WMD, 0.98; 95% CI, 0.69-1.26; P<.0001; I2=0%).

However, in subanalyses of the first 3 months of follow-up, this difference was not significant for MoCA score (WMD, 1.20; 95% CI, –0.19 to 2.58; P=.09; I2=50%) or cognitive function scores (standard mean difference, 0.39; 95% CI, –0.47 to 1.24; P=.38; I2=87%).

Overall, the authors felt their data suggested an association between catheter ablation for atrial fibrillation and improved cognitive outcomes compared with foregoing ablation in patients with atrial fibrillation.

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