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Randomized Controlled Trial
. 2023 Jul;9(7 Pt 2):1024-1034.
doi: 10.1016/j.jacep.2023.02.020. Epub 2023 May 24.

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

Ahmed M Al-Kaisey  1 , Ramanathan Parameswaran  1 , Christina Bryant  2 , Robert D Anderson  3 , Joshua Hawson  3 , David Chieng  4 , Aleksandr Voskoboinik  4 , Hariharan Sugumar  4 , Danielle West  5 , Sonia Azzopardi  4 , Sue Finch  6 , Geoffrey Wong  3 , Stephen A Joseph  5 , Alex McLellan  5 , Liang-Han Ling  4 , Prashanthan Sanders  7 , Geoffrey Lee  3 , Peter M Kistler  8 , Jonathan M Kalman  9
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Free article
Randomized Controlled Trial

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

Ahmed M Al-Kaisey et al. JACC Clin Electrophysiol. 2023 Jul.
Free article

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.

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Conflict of interest statement

Funding Support and Author Disclosures Drs Al-Kaisey, Parameswaran, Wong, Anderson, Voskoboinik, Chieng, and Sugumar are supported by the National Health and Medical Research Council research scholarship. Prof Kalman is supported by a practitioner fellowship from the National Health and Medical Research Council; has received research support from Biosense Webster, Boston Scientific, Abbott, and Medtronic; and has served on the advisory board of Boston Scientific and Biosense Webster. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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