Catheter ablation of atrial fibrillation reduces the risk of dementia and hospitalization during a very long-term follow-up. (1st April 2020) - Hsieh, Yu-Cheng
Abstract: Background: Atrial fibrillation (AF) is associated with increased risks of dementia and hospitalization. Whether catheter ablation (CA) for AF might reduce such risks remains unclear. We aimed to investigate the effects of CA on dementia and hospitalization risks during a very long-term follow-up. Methods: We studied a total of 787 AF patients receiving CA for AF treatment from 2003 to 2012 (AF CA group). The propensity score of this group was matched to another two cohorts: (a) AF patients without CA (AF no CA, n = 787) and (b) control patients without AF (n = 770). New onset of dementia of each subject was identified by ICD-9-CM codes, and information on hospitalization for AF was based on medical records. The Cox proportional hazards model was used to determine the hazard ratios (HRs) for events. Results: During 9.0 ± 2.6 year's follow-up, a total of 139 dementia events and 732 AF-related hospitalizations have occurred. AF CA group has lower incidence of dementia than AF no CA group (adjusted HR: 0.44, p = 0.005). AF related hospitalizations were also lower in the AF CA group than that in AF no CA group (adjusted HR: 0.72, p < 0.05). In AF patients aged >65 years, CA reduced the risk of dementia compared to those without CA (adjusted HR: 0.46, p = 0.03). Conclusions: In a 9-year follow-up, we found that CA had reduced the risk of dementia and hospitalization in AF patients, compared with those without CA. Such reduction in the risk of dementia was particularly clear in older AF patients (aged >65 years). Highlights: Catheter ablation (CA) in atrial fibrillation (AF) patients reduced the long-term risk of dementia and hospitalization. The risk of dementia was similar between AF patients receiving CA and those without history of AF. CA in AF patients has a lower risk of dementia than AF patients without CA, particularly in older patients aged >65 years. The dementia risk was higher in CA patients with AF hospitalization occurred ≤ 5 years than those without hospitalization.