Impact of Catheter Ablation on Cognitive Function in Atrial Fibrillation A Randomized Control Trial

被引：15

作者：

Al-Kaisey, Ahmed M. ^{[1
,2
,3
]}

Parameswaran, Ramanathan ^{[1
,2
,3
]}

Bryant, Christina ^{[4
,5
]}

Anderson, Robert D. ^{[1
,2
]}

Hawson, Joshua ^{[1
,2
]}

Chieng, David ^{[3
,5
,6
]}

Voskoboinik, Aleksandr ^{[3
,5
,6
]}

Sugumar, Hariharan ^{[3
,5
,6
]}

West, Danielle

Azzopardi, Sonia ^{[2
,3
,5
,6
]}

Finch, Sue ^{[7
]}

Wong, Geoffrey ^{[1
]}

Joseph, Stephen A. ^{[1
]}

Mclellan, Alex ^{[1
]}

Ling, Liang-Han ^{[2
,3
,6
]}

Sanders, Prashanthan ^{[8
]}

Lee, Geoffrey ^{[1
]}

Kistler, Peter M. ^{[2
,3
,6
]}

Kalman, Jonathan M. ^{[1
,9
]}

机构：

[1] Royal Melbourne Hosp, Dept Cardiol, Melbourne, Australia

[2] Univ Melbourne, Dept Med, Melbourne, Vic, Australia

[3] Alfred Hosp, Heart Ctr, Melbourne, Vic, Australia

[4] Univ Melbourne, Melbourne Sch Psychol Sci, Melbourne, Australia

[5] Royal Womens Hosp, Clin Psychol, Melbourne, Australia

[6] Baker IDI Heart & Diabet Inst, Melbourne, Australia

[7] Univ Melbourne, Sch Math & Stat, Melbourne, Australia

[8] Univ Adelaide, Royal Adelaide Hosp, Ctr Heart Rhythm Disorders, South Australian Hlth & Med Res Inst, Adelaide, Australia

[9] Royal Melbourne Hosp, Dept Cardiol, Australia, Level 2,300 Grattan St, Parkville 3050, Australia

来源：

JACC-CLINICAL ELECTROPHYSIOLOGY | 2023年 / 9卷 / 07期

基金：

英国医学研究理事会;

关键词：

arrhythmia outcomes; atrial fibrillation; catheter ablation; cognitive function; postoperative cognitive dysfunction; ASYMPTOMATIC CEREBRAL-LESIONS; PULMONARY VEIN ISOLATION; QUALITY-OF-LIFE; TERM-FOLLOW-UP; DEMENTIA; STROKE; DEATH;

D O I：

10.1016/j.jacep.2023.02.020

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Early postoperative cognitive dysfunction (POCD) has been reported following atrial fibrillation (AF) ablation. However, whether POCD is persistent long-term is unknown. OBJECTIVES The purpose of this study was to determine if AF catheter ablation is associated with persistent cognitive dysfunction at 12-month follow-up. METHODS This is a prospective study of 100 patients with symptomatic AF who failed at least 1 antiarrhythmic drug randomized to either ongoing medical therapy or AF catheter ablation and followed up for 12 months. Changes in cognitive performance were assessed using 6 cognitive tests administered at baseline and during follow-up (3, 6, and 12 months). RESULTS A total of 96 participants completed the study protocol. Mean age was 59 +/- 12 years (32% women, 46% with persistent AF). The prevalence of new cognitive dysfunction in the ablation arm compared with the medical arm was as follows: at 3 months: 14% vs 2%; P = 0.03; at 6 months: 4% vs 2%; P = NS; and at 12 months: 0% vs 2%; P = NS. Ablation time was an independent predictor of POCD (P = 0.03). A significant improvement in cognitive scores was seen in 14% of the ablation arm patients at 12 months compared with no patients in the medical arm (P = 0.007). CONCLUSIONS POCD was observed following AF ablation. However, this was transient with complete recovery at 12-month follow-up. (c) 2023 by the American College of Cardiology Foundation.

引用

页码：1024 / 1034

页数：11

共 23 条

[1] Patients Treated with Catheter Ablation for Atrial Fibrillation Have Long-Term Rates of Death, Stroke, and Dementia Similar to Patients Without Atrial Fibrillation [J].