Catheter Ablation for Atrial Fibrillation Shows No Short-Term Cognitive Harm: JAMA
A prospective cohort study published in JAMA Network Open found that catheter ablation for atrial fibrillation was not associated with short-term cognitive decline. The findings suggest that the procedure does not adversely affect cognitive function in the months following treatment, providing reassurance about its neurological safety while supporting its use for managing atrial fibrillation. The study was conducted by Sotirios C. and colleagues.
For assessing longitudinal changes in cognition, participants undergoing catheter ablation (CA) were consecutively recruited along with the corresponding nonablation group during the period from January 2022 through June 2024. The interventional subjects underwent ablation in the form of cryoballoon ablation or pulsed field ablation (PFA). Neurocognitive assessment was performed both before and 6 months following the procedure through the use of the conventional Montreal Cognitive Assessment (MoCA) as well as the innovative REMEDES for Alzheimer (R4Alz) neurocognitive battery that assesses executive functions. In addition, brain MRI was conducted pre- and post-ablation procedure to identify the occurrence of any silent cerebral infarcts.
Key findings:
- A group of 75 ablation patients and a group of 40 nonablation patients suffering from atrial fibrillation were included in the study.
- In the ablation group, there were 40 females and the average age was 61.9 years old, 54 patients underwent cryoballoon ablation while 21 underwent pulmonary vein ablation.
- In both patient groups, no change in cognitive scores was observed.
- Neuroimaging carried out after the procedure did not indicate any new cerebral infarcts among ablation patients during the 48-hour period following catheter ablation treatment.
- The MoCA scores in the ablation group were changed by an insignificant number of 0.27 points while the R4Alz scores increased significantly by 2.81 points due to short-term memory improvement.
- The ablation patients demonstrated significantly larger cognitive improvements than non-ablation patients.
- It was proved by the difference in changes of MoCA (mean difference = 0.74; P = .01) and R4Alz scores (mean difference = 3.18; P = .007).
- Results from the multivariable analysis indicated that catheter ablation has higher mean scores according to the follow-up MoCA (beta = 0.88; 95% CI, 0.31 to 1.44) and R4Alz test (beta = 3.80; 95% CI, 1.70 to 5.90).
In this study involving 75 patients who were treated with CA for AF, no association between ablation and cognitive impairment was found; on the contrary, there was a modest improvement in selected cognitive domains. This study showed that domain-based assessment revealed changes that could not be observed via global cognitive testing.
Reference:
Chiotis S, Giannopoulos G, Zagalioti S, et al. Global and Domain-Specific Cognitive Outcomes After Catheter Ablation for Atrial Fibrillation. JAMA Netw Open. 2026;9(7):e2626642. doi:10.1001/jamanetworkopen.2026.26642
