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

Ahmed M Al-Kaisey; Ramanathan Parameswaran; Christina Bryant; Robert D Anderson; Joshua Hawson; David Chieng; Aleksandr Voskoboinik; Hariharan Sugumar; Danielle West; Sonia Azzopardi; Sue Finch; Geoffrey Wong; Stephen A Joseph; Alex McLellan; Liang-Han Ling; Prashanthan Sanders; Geoffrey Lee; Peter M Kistler; Jonathan M Kalman
Early postoperative cognitive dysfunction (POCD) has been reported following atrial fibrillation (AF) ablation. However, whether POCD is persistent long-term is unknown.The purpose of this study was to determine if AF catheter ablation is associated with persistent cognitive dysfunction at 12-month follow-up.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).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).POCD was observed following AF ablation. However, this was transient with complete recovery at 12-month follow-up.
ISSN 2405-5018
Published 10 Apr 2023
DOI 10.1016/j.jacep.2023.02.020
Type Journal Article