Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2021 Aug 13;100(32):e26914. doi: 10.1097/MD.0000000000026914.
Atrial fibrillation is considered to be the most common arrhythmia in the clinic, and it gradually increases with age. In recent years, there has been increasing evidence that atrial fibrillation may exacerbate the progression of cognitive dysfunction. The current guidelines recommend ablation for drug-refractory atrial fibrillation.We aimed to prospectively analyze changes in cognitive function in patients with atrial fibrillation following treatment using different ablation methods.A total of 139 patients, with non-valvular atrial fibrillation, were included in the study. The patients were divided into the drug therapy (n = 41) and catheter ablation (n = 98) groups, with the catheter ablation group further subdivided into radiofrequency ablation (n = 68) and cryoballoon (CY) ablation (n = 30). We evaluated cognitive function at baseline, 3- and 12-months follow-up using the Telephone Interview for Cognitive Status-modified (TICS-m) test, then analyzed differences in cognitive function between the drug therapy and catheter ablation groups, to reveal the effect of the different ablation methods.We observed a significantly higher TICS-m score (39.56 ± 3.198) in the catheter ablation group at 12-month follow-up (P < .001), than the drug treatment group was. Additionally, we found no statistically significant differences in TICS-m scores between the radiofrequency ablation and CY groups at 3- and 12-month postoperatively (P > .05), although the two subgroups showed statistically significant cognitive function (P < .001).Overall, these findings indicated that radiofrequency and CY ablation improve cognitive function in patients with atrial fibrillation.
心房颤动被认为是临床上最常见的心律失常,并且随着年龄的增长逐渐增加。近年来,越来越多的证据表明心房颤动可能会加剧认知功能障碍的进展。目前的指南建议对药物难治性心房颤动进行消融治疗。我们旨在前瞻性分析不同消融方法治疗心房颤动患者的认知功能变化。
共有 139 名非瓣膜性心房颤动患者纳入研究。患者分为药物治疗组(n = 41)和导管消融组(n = 98),导管消融组进一步分为射频消融组(n = 68)和冷冻球囊消融组(CY 消融组)(n = 30)。我们使用电话访谈认知状态修正测试(TICS-m)在基线、3 个月和 12 个月时评估认知功能,然后分析药物治疗和导管消融组之间认知功能的差异,以揭示不同消融方法的效果。
我们观察到在 12 个月的随访中,导管消融组的 TICS-m 评分(39.56 ± 3.198)明显更高(P < .001),而药物治疗组则更低。此外,我们发现射频消融和 CY 消融组在术后 3 个月和 12 个月时 TICS-m 评分无统计学差异(P > .05),尽管两个亚组的认知功能均有统计学意义(P < .001)。
总之,这些发现表明射频和 CY 消融可改善心房颤动患者的认知功能。