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Updated: Feb 14, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Neurocognitive Function, Cerebral Blood Flow, and Hippocampal Volume After Catheter Ablation of Atrial Fibrillation
Tasuku Yamamoto1, Yoshihide Takahashi2, Shunsuke Takagi3
1Department of Cardiovascular Medicine, Institute of Science Tokyo, Tokyo, Japan.
Background:
The effect of atrial fibrillation (AF) catheter ablation on neurocognitive function is debated.
Objectives:
This study sought to investigate changes in cognitive function and brain imaging after AF ablation.
Methods:
Patients undergoing AF catheter ablation were screened. Participants underwent assessments of neurocognitive function using the Cambridge Neuropsychological Test Automated Battery before and 3 and 6 months after ablation. Patients with AF managed by drug therapy served as a control group. A subset of patients underwent brain magnetic resonance imaging before and 6 months after the procedure, where cerebral blood flow (CBF) and bilateral hippocampal volume (HV) were assessed.
Results:
A total of 145 patients, 94 in the ablation group and 51 in the control group (aged 64 ± 11 years, 70% men, 41% with paroxysmal AF), were studied. Changes in neurocognitive function tests scores were not significantly different between groups. Arrhythmia recurrence and AF type (paroxysmal or persistent) did not significantly affect the outcome. In the magnetic resonance imaging subgroup (n = 51: ablation 42 and control 9), change in CBF (ΔCBF) and proportional change in HV were significantly different between groups (+46 mL/min [IQR: -17 to +111] vs -45 mL/min [IQR: -70 to +9], P = 0.007; +0.1% [IQR: -1.1 to +0.8] vs -1.0% [IQR: -2.0 to +0.1], P = 0.043; for ablation vs control, respectively). Those with ΔCBF more than +35 mL/min had greater improvements in memory and new learning score than those with ΔCBF less than +35 mL/min (+2 [IQR: -0.5 to +5] vs 0 [IQR: -3 to +3], P = 0.048).
Conclusions:
In this study, AF ablation did not significantly affect neurocognitive function at the 6-month follow-up. Compared with drug therapy, ablation was associated with greater changes in CBF and HV, and patients with CBF improvement, regardless of treatment assignment, showed improved performance in memory and new learning.
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