Po-02-093 impact of ablation outcome on cognitive function in patients with atrial fibrillation

Emerging evidences suggest increased risk of all forms of dementia in patients with atrial fibrillation (AF) even in the absence of overt stroke. Cerebral hypoperfusion and the risk of cerebrovascular micro- and macro-embolism are plausible explanations for the predisposition for cognitive decline in AF. We evaluated the impact of ablation outcome on cognitive function in AF patients. Consecutive patients receiving AF ablation were screened prior to the procedure and consenting subjects were enrolled in our COGNITION registry (NCT01816308). Cognitive function was assessed using the Montreal cognitive assessment (MoCA) survey. Patients with baseline MoCA score of ≤17 were excluded from the analysis. In this survey, with a scale of 0-30, 27-30 is considered normal cognition, 18-26 as mild cognitive impairment (MCI) and ≤ 17 as dementia. Post-ablation MoCA survey was conducted at 1 year. Change in MoCA score of 1.7 points was considered clinically significant. Standard institutional protocol was followed to monitor patients for arrhythmia recurrence at quarterly interval during the 1-year follow-up period. A total of 576 AF patients receiving their first catheter ablation were enrolled in the COGNITION registry. At 1 year, 191 (33.1%) patients experienced recurrence (group 1) and 385 remained arrhythmia-free off-drugs (group 2). Baseline characteristics of the study population is given in table 1. Baseline MoCA score was 20±3.7 in group 1 vs 19.2±3.8 in group 2 (p=0.09). At 1-year follow-up, mean MoCA score was significantly lower from the baseline score in group 1 (16.05±4.4, p<0.001) and higher (21.7±2.4, p<0.001) in group 2. Mean change in the MoCA score was -5.08±4.3 and 2.9±2.6 in group 1 and 2 respectively (p<0.001). In this series, significant change in cognitive function was observed following catheter ablation; MoCA score declined substantially in patients experiencing recurrence and improved in those that remained arrhythmia-free.