Related Experiment Video

Updated: Jun 23, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.2K

Impact of Silent Cerebral Embolism during and after Left Atrial Appendage Occlusion on Long-Term Cognitive Function

Kexin Wang1, Zhe Wang2, Caiyi Jin1

  • 1Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China.

Journal of the American Heart Association
|February 3, 2025
PubMed

Insights

Left atrial appendage occlusion (LAAO) can cause silent cerebral embolism (SCE), leading to irreversible cognitive decline. New SCE during follow-up also impairs cognitive function, highlighting the need for monitoring after LAAO procedures.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Left atrial appendage occlusion (LAAO) is linked to a high rate of silent cerebral embolism (SCE).
  • Limited data exist on the long-term cognitive effects following LAAO procedures.
  • This study aimed to evaluate the acute and long-term cognitive impact of SCE in LAAO patients.

Purpose of the Study:

  • To assess the immediate and long-term cognitive consequences of silent cerebral embolism (SCE) in patients undergoing left atrial appendage occlusion (LAAO).
  • To investigate the relationship between new SCE events during follow-up and cognitive function.
  • To determine the reversibility of cognitive decline post-LAAO related SCE.

Main Methods:

  • 75 patients with atrial fibrillation undergoing LAAO were included.
  • Magnetic resonance imaging and cognitive assessments (MMSE, MoCA) were performed pre-procedure, within 48 hours post-procedure, and at 45-day, 3-month, 6-month, and 1-year follow-ups.
  • Cognitive function and incidence of new SCE were analyzed over time.

Main Results:

  • 29% of patients developed new SCE during LAAO, showing significant immediate cognitive decline (MMSE, P<0.001) that was irreversible at 1-year.
  • Cognitive function gap widened between patients with and without SCE over 1 year (P<0.001).
  • 14.7% of patients had new SCE during follow-up, associated with cognitive decline (P=0.004).

Conclusions:

  • LAAO-related SCE causes significant, irreversible cognitive impairment immediately after the procedure and over 1-year follow-up.
  • New SCE detected during follow-up after LAAO is also associated with cognitive decline.
  • These findings underscore the importance of monitoring cognitive function in patients post-LAAO.
Abstract

Keywords:
anticoagulationatrial fibrillationcognitive functionleft atrial appendagesilent cerebral embolism

More Related Videos

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection08:22

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

Published on: July 21, 2013

14.9K
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

2.9K

Related Concept Videos

Long-term Depression01:05

Long-term Depression

Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
Long-term Depression01:03

Long-term Depression

Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
Calcium Ion Concentration Mechanism
If over time, all...
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Role of Cerebellum and Prefrontal Cortex in Memory01:14

Role of Cerebellum and Prefrontal Cortex in Memory

The cerebellum, while traditionally associated with motor control, also plays a crucial role in memory, particularly in procedural memory, which involves learning motor tasks that become automatic through repetition. For example, studies have shown that when the cerebellum is damaged, individuals or animals lose the ability to learn conditioned motor responses, such as the conditioned eye-blink response in classical conditioning experiments with rabbits. This study demonstrates the cerebellum's...
Hepatic Encephalopathy01:29

Hepatic Encephalopathy

DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...