Study compares risk of dementia in AF patients undergoing catheter ablation versus drug-therapy


Biosense Webster has announced the publication of data from a study comparing the risk of dementia in patients with atrial fibrillation (AF) who were treated with catheter ablation versus anti-arrhythmic drugs (AAD) in the American Heart Journal.

The study evaluated non-specific catheter claims information and found that catheter ablation was associated with significantly lower risk of dementia compared to treatment with AAD only.

AF is associated with significant cardiovascular comorbidity, including multiple forms of brain injury such as stroke, cognitive impairment and dementia. Historically, dementia in patients with AF was attributed to multiple strokes; however, studies have shown that AF is associated with multiple forms of dementia, even in the absence of stroke.

“Atrial fibrillation and dementia independently are a growing concern with the ageing of our population. Through this study we sought to better understand the complex relationship between AF and dementia by exploring how treatment type for AF plays a role in the development of dementia, and how clinicians might reduce this risk,” said Emily P Zeitler (Geisel School of Medicine, Dartmouth, USA). “Catheter ablation, as a course of AF treatment, may reduce this risk.”

AF suppression, or “rhythm control,” often becomes the treatment goal following an AF diagnosis. This is often attempted first with AAD. For those eligible, catheter ablation is associated with greater reduction in AF burden, improved quality of life, and reduced mortality and cardiovascular hospitalisations.

According to the study, AF patients treated with catheter ablation had a 41% lower risk of dementia compared with those treated with anti-arrhythmic drugs (1.9% vs 3.3%; hazard ratio [HR] 0.59, 95% confidence interval [CI] 0.52-0.67)12. Reduced risk of dementia was observed among both male and female subgroups. The reduction in the risk for dementia associated with catheter ablation versus AAD for the subgroup of female patients was 40%; in males it was 45%13.

“Research like this supports the hypothesis that AFib suppression may reduce the risk of developing dementia,” said Jamie March, head of health economics and market access, Cardiovascular Specialty Solutions Group, Biosense Webster. “That understanding underscores the importance of innovations like catheter ablation to the large and growing AF patient population.”


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