Abstract

Catheter ablation is an important non-pharmacological intervention for atrial fibrillation (AF), but its effect on the incidence of asymptomatic cerebral emboli and long-term effects on cognitive function remain unknown. We prospectively enrolled 101 patients who underwent AF ablation. Brain magnetic resonance imaging (MRI) (72 patients) and neuropsychological assessments (66 patients) were performed 1–3 days (baseline) and 6 months after ablation. Immediately after ablation, diffusion-weighted MRI and 3-dimensional double inversion recovery (3D-DIR) detected embolic microinfarctions in 63 patients (87.5%) and 62 patients (86.1%), respectively. After 6 months, DIR lesions disappeared in 41 patients. Microbleeds (MBs) increased by 17%, and 65% of the de novo MBs were exactly at the same location as the microinfarctions. Average Mini-Mental State Examination scores improved from 27.9 ± 2.4 to 28.5 ± 1.7 (p = 0.037), and detailed neuropsychological assessment scores showed improvement in memory, constructional, and frontal lobe functions. Ejection fraction, left atrial volume index and brain natriuretic peptide level improved from baseline to 3–6 months after ablation. Despite incidental microemboli, cognitive function was preserved 6 months after ablation.

Details

Title
Brain magnetic resonance imaging and cognitive alterations after ablation in patients with atrial fibrillation
Author
Kato Natsuko 1 ; Muraga Kanako 2 ; Hirata Yoshinori 3 ; Shindo Akihiro 3 ; Matsuura Keita 3 ; Ii Yuichiro 3 ; Shiga Mariko 1 ; Tabei Ken-ichi 1 ; Satoh Masayuki 1 ; Fujita Satoshi 4 ; Fukuma Tomoyuki 4 ; Kagawa Yoshihiko 4 ; Fujii Eitaro 4 ; Umino Maki 5 ; Maeda Masayuki 6 ; Sakuma Hajime 5 ; Ito Masaaki 4 ; Tomimoto Hidekazu 3 

 Mie University Graduate School of Medicine, Department of Neurology, Tsu, Japan (GRID:grid.260026.0) (ISNI:0000 0004 0372 555X); Mie University Graduate School of Medicine, Department of Dementia Prevention and Therapeutics, Tsu, Japan (GRID:grid.260026.0) (ISNI:0000 0004 0372 555X) 
 Mie University Graduate School of Medicine, Department of Neurology, Tsu, Japan (GRID:grid.260026.0) (ISNI:0000 0004 0372 555X); Nippon Medical School, Department of Neurologic Science, Graduate School of Medicine, Tokyo, Japan (GRID:grid.410821.e) (ISNI:0000 0001 2173 8328) 
 Mie University Graduate School of Medicine, Department of Neurology, Tsu, Japan (GRID:grid.260026.0) (ISNI:0000 0004 0372 555X) 
 Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan (GRID:grid.260026.0) (ISNI:0000 0004 0372 555X) 
 Mie University Graduate School of Medicine, Department of Radiology, Tsu, Japan (GRID:grid.260026.0) (ISNI:0000 0004 0372 555X) 
 Mie University Graduate School of Medicine, Department of Neuroradiology, Tsu, Japan (GRID:grid.260026.0) (ISNI:0000 0004 0372 555X) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2575651277
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.