Catheter ablation for atrial fibrillation and risk of neurologic disease

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Heart Rhythm O2 Pub Date : 2025-01-01 DOI:10.1016/j.hroo.2024.11.004

Mohammed Al-Sadawi MBBCh, Nithi Tokavanich MD, Jasneet Devgun MD, Michael Ghannam MD, Rakesh Latchamsetty MD, Krit Jongsarangsin MD, Hakan Oral MD

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Abstract

Background

Catheter ablation (CA) of atrial fibrillation (AF) has been proven to benefit patients with symptomatic AF and heart failure. However, the data on neurological outcomes including cerebrovascular accidents (CVA) and dementia remain controversial.

Objective

We aimed to determine the effect of CA on neurological events during long-term follow-up.

Methods

We performed a systematic review and meta-analysis of patients with AF who underwent CA of AF. The MEDLINE, EMBASE, and Web of Science databases were comprehensively searched from inception to January 2024. Studies that reported incidence of CVA and dementia in patients with AF were. Data from each study were combined by a random-effects model. The results were reported in risk ratios with 95% confidence intervals (CIs).

Results

A total of 29 studies and 379,993 patients (mean age 58 ± 4 years, 30% women) were included in the analysis. Mean follow-up was 36 ± 23 months (range 12–120 months). Patients who underwent CA of AF had a lower risk of developing CVA compared with medical management (odds ratio [OR] 0.54, 95% CI 0.42–0 69, I² = 91%). Moreover, the risk of dementia was lower in the CA group compared with medical management (OR 0.51, 95% CI 0.4–0.66, I² = 74%). The incidence of CVA in the CA group was 1% (95% CI 1%–2%, I² = 97%), and the incidence of dementia was 2% (95% CI 2%–8%, I² = 97%).