Ablation reduces risk of dementia in patients with atrial fibrillation

Researchers from a newly published study report that, among patients with atrial fibrillation, the risk of developing dementia among those who underwent catheter ablation was about half that of the patients who did not undergo the procedure.

The findings were published on August 23, 2023 in the Journal of the American Geriatrics Society.

“In our large study people with atrial fibrillation had a lower risk of dementia if they had catheter ablation, and this was upheld irrespective of age, sex, and other health conditions,” said author Stephanie Harrison, BSc (Hons), MSc, PhD, of the University of Liverpool (UK). “This could be an important consideration when determining appropriate treatment options for patients with atrial fibrillation.”

As background, the authors noted that atrial fibrillation (AF) has been associated with an elevated risk of dementia. Some studies have suggested that catheter ablation may be associated with a lower risk of dementia in patients with AF.

“The objectives of this study were to use a global health research network to examine associations between catheter ablation, incident dementia and mortality in older adults with AF, and among subgroups by age, sex, co-morbidity status, and oral anticoagulant use,” the authors said.

The research network from which the data was gathered included mostly healthcare organizations in the United States. This network was searched on September 28, 2022 for patients aged ≥65 years with a diagnosis of AF which was received at least 5 years prior to the search date.

The investigators included 20,746 subjects (mean age 68 years; 59% male) in each cohort, defined respectively as those with and without a history of catheter ablation.

The cohorts were balanced for age, sex, ethnicity, co-morbidities, and cardiovascular medications.

The researchers reported that the risk of developing dementia was approximately 48% lower in atrial fibrillation patients who underwent catheter ablation compared with those who did not.

They also reported that the catheter ablation cohort had a lower risk of death from any cause.

The findings held in subgroup analyses of subjects aged 65–79 years, those aged ≥80 years, male subjects, female subjects and those who were treated with anticoagulant medications during follow-up.

The findings also held for subjects with either paroxysmal or non-paroxysmal atrial fibrillation and those with and without hypertension, diabetes, ischemic stroke, chronic kidney disease, and heart failure.

The authors concluded, “The observed lower risk of dementia and mortality with catheter ablation could be an important consideration when determining appropriate patient-centered rhythm control strategies for patients with AF. Further studies including data on the success of ablation are required.”