In catheter ablation for atrial fibrillation
Possible reduction in dementia risk
Catheterization of atrial fibrillation may be effective in preventing dementia.
Dementia is an important topic of great interest in Japan, which is facing a super-aging society. Several studies have pointed out the relationship between atrial fibrillation and dementia. In 2019, a Korean research group reported that dementia risk increased in patients with atrial fibrillation, even if they had not developed a stroke (cerebral infarction or cerebral hemorrhage).
(1) In 2020, the same research group reported research results on new catheter treatment for atrial fibrillation. Atrial fibrillation patients treated with catheter ablation (9,119 patients) reported a 27% reduction in dementia risk compared to drug therapy (17,978 patients).
(2) A significant reduction in dementia risk was observed even after excluding stroke cases. Furthermore, successful catheterization was significantly more effective, with a 44% reduction compared to drug therapy, while failure was not associated with a significant reduction in dementia risk.
The research group speculates that the suppression of vascular microcerebral infarction and cerebral white matter lesions by catheter treatment may contribute. Further randomized controlled trials are needed in the future, but it is an interesting theme whether rhythm control for atrial fibrillation (cure atrial fibrillation itself) or rate control (heart rate control) is related to dementia risk reduction. .
Medical Corporation CVIC Chairman Masahiro Terashima
1. Kim D, Yang PS, Yu HT, et al. Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: Data from a population-based cohort. Eur. Heart J. 2019;40:2313–2323._cc781905- 5cde-3194-bb3b-136bad5cf58d_
2. Kim D, Yang P-SY, Sung JH, et al. Less dementia after catheter ablation for atrial fibrillation: a nationwide cohort study - Eur. Heart J. 2020;ehaa726..