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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter ablation for atrial fibrillation and risk of neurologic disease

Mohammed Al-Sadawi1, Nithi Tokavanich1, Jasneet Devgun1

  • 1Clinical Cardiac Electrophysiology Department, University of Michigan Hospital, Ann Arbor, Michigan.

Heart Rhythm O2
|April 14, 2025
PubMed

Insights

Catheter ablation for atrial fibrillation significantly reduces the risk of stroke and dementia compared to medical management alone. This long-term study confirms catheter ablation

Area of Science:

  • Cardiology
  • Neurology
  • Medical Interventions

Background:

  • Catheter ablation (CA) for atrial fibrillation (AF) is established for symptomatic AF and heart failure.
  • Neurological outcomes, including stroke and dementia, post-CA for AF remain debated.

Purpose of the Study:

  • To evaluate the long-term impact of catheter ablation on neurological events in AF patients.
  • To compare the incidence of cerebrovascular accidents (CVA) and dementia after CA versus medical management.

Main Methods:

  • Systematic review and meta-analysis of 29 studies including 379,993 AF patients.
  • Searched MEDLINE, EMBASE, and Web of Science databases up to January 2024.
  • Employed random-effects models to calculate risk ratios and 95% confidence intervals (CIs).

Main Results:

  • Catheter ablation was associated with a significantly lower risk of CVA (OR 0.54, 95% CI 0.42-0.69) and dementia (OR 0.51, 95% CI 0.4-0.66) compared to medical management.
  • The incidence of CVA in the CA group was 1% (95% CI 1%-2%), and dementia was 2% (95% CI 2%-8%).
  • Mean follow-up duration was 36 months, with a range of 12-120 months.

Conclusions:

  • Catheter ablation for atrial fibrillation leads to a reduced risk of cerebrovascular accidents and dementia.
  • These neurological benefits are observed during long-term follow-up when compared to medical management alone.
Abstract

Keywords:
AblationAtrial fibrillationCVADementiaOutcomes

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