Atrial Fibrillation Catheter Ablation Improves 1-Year Follow-Up Cognitive Function, Especially in Patients With Impaired Cognitive Function
BACKGROUND:Although atrial fibrillation (AF) has a risk of cognitive dysfunction, it is not clear whether AF catheter ablation improves or worsens cognitive function. This prospective case-control study sought to assess the 1-year serial changes in the cognitive function with or without AF catheter...
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| Veröffentlicht in: | Circulation. Arrhythmia and electrophysiology 2019-07, Vol.12 (7), p.e007197-e007197 |
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| container_title | Circulation. Arrhythmia and electrophysiology |
| container_volume | 12 |
| creator | Jin, Moo-Nyun Kim, Tae-Hoon Kang, Ki-Woon Yu, Hee Tae Uhm, Jae-Sun Joung, Boyoung Lee, Moon-Hyoung Kim, Eosu Pak, Hui-Nam |
| description | BACKGROUND:Although atrial fibrillation (AF) has a risk of cognitive dysfunction, it is not clear whether AF catheter ablation improves or worsens cognitive function. This prospective case-control study sought to assess the 1-year serial changes in the cognitive function with or without AF catheter ablation.
METHODS:We evaluated the Montreal Cognitive Assessment score in 308 patients (71.4% male, 60.6±9.1 years of age, 34.1% persistent AF) who underwent AF ablation (ablation group) and 50 AF patients on medical therapy who met the same indication for AF ablation (control group), at baseline and 3 and 12 months after enrollment. Cognitive impairment was defined as a published cutoff score of |
| doi_str_mv | 10.1161/CIRCEP.119.007197 |
| format | Article |
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METHODS:We evaluated the Montreal Cognitive Assessment score in 308 patients (71.4% male, 60.6±9.1 years of age, 34.1% persistent AF) who underwent AF ablation (ablation group) and 50 AF patients on medical therapy who met the same indication for AF ablation (control group), at baseline and 3 and 12 months after enrollment. Cognitive impairment was defined as a published cutoff score of <23 points. To exclude any learning effects, we used the practice-adjusted reliable change index for assessing the cognitive changes.
RESULTS:Preablation cognitive impairment was detected in 18.5% (57/308). The Montreal Cognitive Assessment score significantly improved 1 year after radiofrequency catheter ablation in both overall ablation group (24.9±2.9–26.4±2.5; P<0.001) and the propensity-matched ablation group (25.4±2.4–26.5±2.3; P<0.001), but not in the control group (25.4±2.5–24.8±2.5; P=0.012). Preablation cognitive impairment (odds ratio, 13.70; 95% CI, 4.83–38.87; P<0.001) was independently associated with an improvement in the 1-year post-ablation cognitive function. In the reliable change index analyses, 94.7% of propensity-matched ablation group showed an improved/stable cognitive function at the 1-year follow-up.
CONCLUSIONS:Catheter ablation of AF, at least, does not deteriorate the cognitive function, but rather improves the performance on 1-year follow-up neurocognitive tests, especially in patients with a preablation cognitive impairment.</description><identifier>ISSN: 1941-3149</identifier><identifier>EISSN: 1941-3084</identifier><identifier>DOI: 10.1161/CIRCEP.119.007197</identifier><identifier>PMID: 31442075</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Aged ; Atrial Fibrillation - complications ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - surgery ; Case-Control Studies ; Catheter Ablation - adverse effects ; Cognition ; Cognitive Dysfunction - complications ; Cognitive Dysfunction - diagnosis ; Cognitive Dysfunction - psychology ; Female ; Heart Rate ; Humans ; Male ; Mental Status and Dementia Tests ; Middle Aged ; Prospective Studies ; Recovery of Function ; Recurrence ; Time Factors ; Treatment Outcome</subject><ispartof>Circulation. Arrhythmia and electrophysiology, 2019-07, Vol.12 (7), p.e007197-e007197</ispartof><rights>2019 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3891-ba5df68a67c531afb89d1303e0087ce81a0acbfa35ed00839d1276ab2182813f3</citedby><cites>FETCH-LOGICAL-c3891-ba5df68a67c531afb89d1303e0087ce81a0acbfa35ed00839d1276ab2182813f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31442075$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jin, Moo-Nyun</creatorcontrib><creatorcontrib>Kim, Tae-Hoon</creatorcontrib><creatorcontrib>Kang, Ki-Woon</creatorcontrib><creatorcontrib>Yu, Hee Tae</creatorcontrib><creatorcontrib>Uhm, Jae-Sun</creatorcontrib><creatorcontrib>Joung, Boyoung</creatorcontrib><creatorcontrib>Lee, Moon-Hyoung</creatorcontrib><creatorcontrib>Kim, Eosu</creatorcontrib><creatorcontrib>Pak, Hui-Nam</creatorcontrib><title>Atrial Fibrillation Catheter Ablation Improves 1-Year Follow-Up Cognitive Function, Especially in Patients With Impaired Cognitive Function</title><title>Circulation. Arrhythmia and electrophysiology</title><addtitle>Circ Arrhythm Electrophysiol</addtitle><description>BACKGROUND:Although atrial fibrillation (AF) has a risk of cognitive dysfunction, it is not clear whether AF catheter ablation improves or worsens cognitive function. This prospective case-control study sought to assess the 1-year serial changes in the cognitive function with or without AF catheter ablation.
METHODS:We evaluated the Montreal Cognitive Assessment score in 308 patients (71.4% male, 60.6±9.1 years of age, 34.1% persistent AF) who underwent AF ablation (ablation group) and 50 AF patients on medical therapy who met the same indication for AF ablation (control group), at baseline and 3 and 12 months after enrollment. Cognitive impairment was defined as a published cutoff score of <23 points. To exclude any learning effects, we used the practice-adjusted reliable change index for assessing the cognitive changes.
RESULTS:Preablation cognitive impairment was detected in 18.5% (57/308). The Montreal Cognitive Assessment score significantly improved 1 year after radiofrequency catheter ablation in both overall ablation group (24.9±2.9–26.4±2.5; P<0.001) and the propensity-matched ablation group (25.4±2.4–26.5±2.3; P<0.001), but not in the control group (25.4±2.5–24.8±2.5; P=0.012). Preablation cognitive impairment (odds ratio, 13.70; 95% CI, 4.83–38.87; P<0.001) was independently associated with an improvement in the 1-year post-ablation cognitive function. In the reliable change index analyses, 94.7% of propensity-matched ablation group showed an improved/stable cognitive function at the 1-year follow-up.
CONCLUSIONS:Catheter ablation of AF, at least, does not deteriorate the cognitive function, but rather improves the performance on 1-year follow-up neurocognitive tests, especially in patients with a preablation cognitive impairment.</description><subject>Aged</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Case-Control Studies</subject><subject>Catheter Ablation - adverse effects</subject><subject>Cognition</subject><subject>Cognitive Dysfunction - complications</subject><subject>Cognitive Dysfunction - diagnosis</subject><subject>Cognitive Dysfunction - psychology</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Mental Status and Dementia Tests</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Recovery of Function</subject><subject>Recurrence</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1941-3149</issn><issn>1941-3084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptUcFu1DAUtBCoLaUfwAX5yKEp78XZxD6uol1YqRJVRYU4WU7ywhq8yWI7XfUb-tN4lS0nDpZH82ZGem8Ye49wg1jip3pzX6_uElY3ABWq6hW7QFVgJkAWr18wFuqcvQ3hF0CJEsszdp64IodqccGel9Fb4_jaNt46Z6IdB16buKVIni-bE7PZ7f34SIFj9oOM5-vRufGQPex5Pf4cbLSPxNfT0B7F13wV9tSmVPfE7cDvUgQNMfDvNm6PScZ66v5jfMfe9MYFujr9l-xhvfpWf8luv37e1MvbrBVSYdaYRdeX0pRVuxBo-kaqDgUIApBVSxINmLbpjVhQlyiRpnlVmiZHmUsUvbhkH-fctNOfiULUOxtaStsPNE5B50KUSiGiTFKcpa0fQ_DU6723O-OfNII-dqDnDhJWeu4geT6c4qdmR90_x8vRk6CYBYfRpSuH3246kNdbMi5uNaAQVaFElgMqqAAgSy-xfwGpIJNa</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Jin, Moo-Nyun</creator><creator>Kim, Tae-Hoon</creator><creator>Kang, Ki-Woon</creator><creator>Yu, Hee Tae</creator><creator>Uhm, Jae-Sun</creator><creator>Joung, Boyoung</creator><creator>Lee, Moon-Hyoung</creator><creator>Kim, Eosu</creator><creator>Pak, Hui-Nam</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201907</creationdate><title>Atrial Fibrillation Catheter Ablation Improves 1-Year Follow-Up Cognitive Function, Especially in Patients With Impaired Cognitive Function</title><author>Jin, Moo-Nyun ; Kim, Tae-Hoon ; Kang, Ki-Woon ; Yu, Hee Tae ; Uhm, Jae-Sun ; Joung, Boyoung ; Lee, Moon-Hyoung ; Kim, Eosu ; Pak, Hui-Nam</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3891-ba5df68a67c531afb89d1303e0087ce81a0acbfa35ed00839d1276ab2182813f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Case-Control Studies</topic><topic>Catheter Ablation - adverse effects</topic><topic>Cognition</topic><topic>Cognitive Dysfunction - complications</topic><topic>Cognitive Dysfunction - diagnosis</topic><topic>Cognitive Dysfunction - psychology</topic><topic>Female</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Mental Status and Dementia Tests</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Recovery of Function</topic><topic>Recurrence</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jin, Moo-Nyun</creatorcontrib><creatorcontrib>Kim, Tae-Hoon</creatorcontrib><creatorcontrib>Kang, Ki-Woon</creatorcontrib><creatorcontrib>Yu, Hee Tae</creatorcontrib><creatorcontrib>Uhm, Jae-Sun</creatorcontrib><creatorcontrib>Joung, Boyoung</creatorcontrib><creatorcontrib>Lee, Moon-Hyoung</creatorcontrib><creatorcontrib>Kim, Eosu</creatorcontrib><creatorcontrib>Pak, Hui-Nam</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jin, Moo-Nyun</au><au>Kim, Tae-Hoon</au><au>Kang, Ki-Woon</au><au>Yu, Hee Tae</au><au>Uhm, Jae-Sun</au><au>Joung, Boyoung</au><au>Lee, Moon-Hyoung</au><au>Kim, Eosu</au><au>Pak, Hui-Nam</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atrial Fibrillation Catheter Ablation Improves 1-Year Follow-Up Cognitive Function, Especially in Patients With Impaired Cognitive Function</atitle><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle><addtitle>Circ Arrhythm Electrophysiol</addtitle><date>2019-07</date><risdate>2019</risdate><volume>12</volume><issue>7</issue><spage>e007197</spage><epage>e007197</epage><pages>e007197-e007197</pages><issn>1941-3149</issn><eissn>1941-3084</eissn><abstract>BACKGROUND:Although atrial fibrillation (AF) has a risk of cognitive dysfunction, it is not clear whether AF catheter ablation improves or worsens cognitive function. This prospective case-control study sought to assess the 1-year serial changes in the cognitive function with or without AF catheter ablation.
METHODS:We evaluated the Montreal Cognitive Assessment score in 308 patients (71.4% male, 60.6±9.1 years of age, 34.1% persistent AF) who underwent AF ablation (ablation group) and 50 AF patients on medical therapy who met the same indication for AF ablation (control group), at baseline and 3 and 12 months after enrollment. Cognitive impairment was defined as a published cutoff score of <23 points. To exclude any learning effects, we used the practice-adjusted reliable change index for assessing the cognitive changes.
RESULTS:Preablation cognitive impairment was detected in 18.5% (57/308). The Montreal Cognitive Assessment score significantly improved 1 year after radiofrequency catheter ablation in both overall ablation group (24.9±2.9–26.4±2.5; P<0.001) and the propensity-matched ablation group (25.4±2.4–26.5±2.3; P<0.001), but not in the control group (25.4±2.5–24.8±2.5; P=0.012). Preablation cognitive impairment (odds ratio, 13.70; 95% CI, 4.83–38.87; P<0.001) was independently associated with an improvement in the 1-year post-ablation cognitive function. In the reliable change index analyses, 94.7% of propensity-matched ablation group showed an improved/stable cognitive function at the 1-year follow-up.
CONCLUSIONS:Catheter ablation of AF, at least, does not deteriorate the cognitive function, but rather improves the performance on 1-year follow-up neurocognitive tests, especially in patients with a preablation cognitive impairment.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>31442075</pmid><doi>10.1161/CIRCEP.119.007197</doi><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1941-3149 |
| ispartof | Circulation. Arrhythmia and electrophysiology, 2019-07, Vol.12 (7), p.e007197-e007197 |
| issn | 1941-3149 1941-3084 |
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| source | MEDLINE; American Heart Association; EZB-FREE-00999 freely available EZB journals |
| subjects | Aged Atrial Fibrillation - complications Atrial Fibrillation - diagnosis Atrial Fibrillation - physiopathology Atrial Fibrillation - surgery Case-Control Studies Catheter Ablation - adverse effects Cognition Cognitive Dysfunction - complications Cognitive Dysfunction - diagnosis Cognitive Dysfunction - psychology Female Heart Rate Humans Male Mental Status and Dementia Tests Middle Aged Prospective Studies Recovery of Function Recurrence Time Factors Treatment Outcome |
| title | Atrial Fibrillation Catheter Ablation Improves 1-Year Follow-Up Cognitive Function, Especially in Patients With Impaired Cognitive Function |
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