- A preliminary study finds people with AFib who underwent catheter ablation were 36% less likely to develop cognitive problems during the study, compared to those treated only with medication.
- Atrial fibrillation, also known as AFib or AF, is one of the most common types of irregular heart rhythms.
- By 2030, an estimated 12 million people in the United States will have AFib, according to the Centers for Disease Control and Prevention.
In the study, researchers found that people with AFib who underwent catheter ablation were 36% less likely to develop cognitive problems during the study, compared to those treated only with medication.
“Previous studies have found that people with arrhythmias may have long-term thinking and memory problems due to how this condition may affect the blood flow to the brain,” study author Dr. Bahadar Srichawla, a neurologist with the University of Massachusetts Chan Medical School in Worcester, said in a news release.
“Our findings show that treatment with catheter ablation is linked to a reduced risk of cognitive impairment,” he said, adding that more research is needed to confirm the results.
The non-peer-reviewed study will be presented April 24 at the American Academy of Neurology’s annual meeting being held in Boston and online.
Atrial fibrillation, also known as AFib or AF, is one of the
AFib causes your heart to beat irregularly and sometimes more quickly than normal. In addition, the upper and lower chambers of the heart are out of sync. This keeps the chambers from filling completely, which causes the heart to pump less blood to the body.
Not everyone with AFib will notice that they have this condition.
Catheter ablation is associated with a better reduction in AFib symptoms, improved quality of life and a lower risk of hospitalization and death, compared to medications.
However, not everyone is eligible for this procedure, which does not always work and can lead to
In the new study, researchers examined data for 887 older adults with AFib. On average, participants were 75 years old, around half were women and over 87% were white.
Around 22% of people received catheter ablation. These people were more likely to have persistent AFib and an implantable cardiac device, compared to those treated only with medication.
At the start of the study, participants took tests to assess their cognitive function, with questions that measured short-term memory, attention, concentration and language. They repeated these tests one and two years later.
These tests did not assess whether a person had dementia, only whether they had difficulty performing certain mental tasks.
People who underwent catheter ablation were 36% less likely to develop cognitive impairment during the two-year study, compared to those who were only treated with medication, the results showed.
In their analysis, researchers took into account other factors that can contribute to the risk of dementia, such as heart disease, kidney disease and sleep apnea.
The results of the study fit with a 2011
A more recent study, published last year in the American Heart Journal, also found a lower risk of dementia among people with AFib who were treated with catheter ablation compared with medication.
Dr. Keith Vossel, neurologist and director of the Mary S. Easton Center for Alzheimer’s Research and Care at UCLA in Los Angeles, cautioned that the new study is not yet peer-reviewed, so the results should be viewed with caution.
Also, the study will need to be published before its impact on clinical practice can be assessed, he said.
However, “it does this add to other research supporting the possible use of certain treatments for reducing dementia risk,” he told Healthline.
One limitation of the new study is that researchers did not measure blood flow to the brain to see if it differed between people treated with catheter ablation versus medication.
Also missing was data on the success rate of the catheter ablation procedure, pointed out Dr. Shephal Doshi, a cardiac electrophysiologist and director of cardiac electrophysiology and pacing at Providence Saint John’s Health Center in Santa Monica, Calif..
“If some people who had ablation were still having AFib, what does that mean [for the risk of dementia]?” he told Healthline.
In addition, because catheter ablation carries risks, people who have this procedure may differ from those who don’t, said Doshi. This kind of “selection bias” can affect the results of a study.
For example, older adults have a higher risk of complications, so they may opt for medications, leaving healthier people in the ablation procedure group.
In addition, studies will need to be done in more diverse populations, he said, to see if the findings are similar for different groups of people.
The possible link between AFib and dementia has been known for some time, although scientists are still trying to determine how strong that association is and why it occurs.
One possible connection is that AFib is a major
If a blood clots leaves the heart and travels to the brain, it can block blood flow in the brain, what’s known as an ischemic stroke. This type of stroke can cause
Some research suggests that AFib may also increase the risk of dementia by causing smaller blood clots or changes in blood flow that affect the brain — even in the absence of stroke.
“There is some thought that when you have atrial fibrillation, your heartbeats are not as efficient,” said Doshi.
So “if there’s a little bit less blood being squeezed out with every heartbeat, it is possible that this causes some strain on the brain that leads to cognitive decline and dementia,” he said.
Previous research on the link between AFib and dementia has been mixed, possibly due to the way the studies were designed, including how researchers controlled for other factors that increase the risk of dementia.
But a recent larger
Decisions about which AFib patients are eligible for catheter ablation are complex, and must balance the risks of the procedure with the benefits to the patient.
Many people with AFib will not develop dementia, but Vossel said the results of the new study provide additional support for catheter ablation.
Patients newly diagnosed with AFib should talk to their doctor about their potential risk of developing dementia, as well as the risks and benefits of various treatments for AFib.
New technology could make catheter ablation an option for more patients by lowering the risks of the procedure.
For example, Doshi pointed to pulsed field ablation technology, which is faster than current methods and has fewer complications. This technology is available in Europe this year, and may be available in the United States in the next year or two, he said.
With safer technology, “if studies like [the new one] continue to show additional [dementia-related] benefits, then we’d be more willing to do the ablation procedure on people who are older and more frail — the ones that are more likely to have dementia or cognitive decline over time,” he said.