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Ablation for AF linked to subtle postoperative cognitive dysfunction
The prevalence of postoperative neurocognitive dysfunction in patients who underwent ablation for atrial fibrillation ranged from 13% to 20%, according to new data.
Researchers in Australia compared patients undergoing ablation for AF (n=120) with a matched control group of patients with AF who were awaiting radiofrequency ablation (n=30). Of the 120 patients who underwent ablation, 60 had paroxysmal AF, 30 had persistent AF and 30 had supraventricular tachycardia. CHADS2 scores were comparable among groups.
Cognitive function was evaluated using eight neuropsychological tests administered at baseline and 2 and 90 days after the procedure.
At 2 days after ablation, 28% of patients with paroxysmal AF, 27% with persistent AF and 13% with supraventricular tachycardia experienced postoperative cognitive dysfunction vs. 0% of patients in the control group (P=.007). Similarly, at 90 days after the procedure, prevalence of postoperative cognitive dysfunction was 13% in patients with paroxysmal AF, 20% in those with persistent AF and 3% in those with supraventricular tachycardia vs. 0% in the control group (P=.03).
Results showed that 24% of the 120 patients who underwent ablation for AF displayed postoperative cognitive dysfunction 2 days after the procedure and 13% at 90 days after the procedure (P=.029). Univariate analysis suggested an association between increasing left atrial access time and postoperative cognitive dysfunction at 2 days (P=.04) and 90 days (P=.03) after the procedure.
“These results were seen in a patient population with predominant CHADS2 scores of 0 to 1, representing the majority of patients undergoing ablation for AF. The long-term implications of these subtle changes require further study,” the researchers wrote.
Disclosure: See the study for a list of relevant financial disclosures.