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https://hdl.handle.net/2440/139730
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Type: | Journal article |
Title: | Impact of Catheter Ablation on Cognitive Function in Atrial Fibrillation: A Randomized Control Trial |
Author: | Al-Kaisey, A.M. Parameswaran, R. Bryant, C. Anderson, R.D. Hawson, J. Chieng, D. Voskoboinik, A. Sugumar, H. West, D. Azzopardi, S. Finch, S. Wong, G. Joseph, S.A. McLellan, A. Ling, L.-H. Sanders, P. Lee, G. Kistler, P.M. Kalman, J.M. |
Citation: | JACC: Clinical Electrophysiology, 2023; 9(7):1024-1034 |
Publisher: | Elsevier |
Issue Date: | 2023 |
ISSN: | 2405-500X 2405-5018 |
Statement of Responsibility: | 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 |
Abstract: | 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. |
Keywords: | arrhythmia outcomes atrial fibrillation catheter ablation cognitive function postoperative cognitive dysfunction |
Rights: | © 2023 by The American College of Cardiology Foundation. |
DOI: | 10.1016/j.jacep.2023.02.020 |
Grant ID: | NHMRC |
Published version: | http://dx.doi.org/10.1016/j.jacep.2023.02.020 |
Appears in Collections: | Medicine publications |
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