European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on arrhythmias and cognitive function: What is the best practice?

Table of Contents 1 Introduction 3 1.1 Evidence review 3 1.2 Relationships with industry and other conflicts 4 2 Decline of cognitive function: terminology and epidemiology 4 2.1 Terminology: cognitive decline, mild cognitive impairment, and dementia 4 2.2 Epidemiology of dementia 4 3 Methods for assessment of cognitive function 4 4 Role of imaging 5 5 Atrial fibrillation and cognitive function 8 5.1 Atrial fibrillation, overt stroke, and cognitive function 8 5.2 Atrial fibrillation, silent stroke, and cognitive function 9 5.3 Atrial fibrillation and cognitive function in the absence of stroke 10 5.4 Assessment of cognitive function in atrial fibrillation patients in clinical practice 11 5.5 Prevention of cognitive dysfunction in atrial fibrillation patients 12 6 Other arrhythmias and cognitive dysfunction 13 6.1 Cognitive dysfunction in patients with regular supraventricular tachycardias 13 6.2 Cognitive impairment after cardiac arrest 13 6.2.1 Brain injury after non-fatal cardiac arrest 13 6.2.2 Memory impairment after cardiac arrest 14 6.2.3 Therapeutic hypothermia to prevent cognitive impairment after cardiac arrest 14 6.3 Cardiac implantable electronic devices and cognitive dysfunction 14 6.4 Catheter ablation 15 6.5 Implications for electrophysiological procedures and cognitive function 16 7 Current knowledge gaps, future directions, and areas for research 19 8 Recommendations 20 References 20 INTRODUCTION This expert consensus statement of the European Heart Rhythm Association (EHRA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS) summarizes the consensus of the international writing group and is based on a thorough review of the medical literature regarding cognitive function in arrhythmias. SEE PDF.] 2This categorization for our consensus document should not be considered as being directly similar to that used for official society guideline recommendations which apply a classification (I-III) and level of evidence (A, B, and C) to recommendations. [...]a green heart indicates a “should do this” consensus statement or indicated treatment or procedure that is based on at least one randomized trial, or is supported by strong observational evidence that it is beneficial and effective. [...]this is a consensus document that includes evidence and expert opinions from several countries. In 2010, 58% of all people with dementia lived in countries with low or middle incomes, with t