Does catheter ablation lower dementia and mortality risks in all groups of older adults with atrial fibrillation?

Previous studies have shown a link between catheter ablation and a lower risk of dementia and premature death for patients with atrial fibrillation. This procedure involves a flexible wire that is inserted into a blood vessel in the groin and guided to the heart where it destroys tissue that is causing rapid and irregular heartbeats.

Until now, it has been unclear whether the associations between catheter ablation and lower dementia and mortality risks hold among different subgroups of patients stratified by age, sex, co-morbidities, and medication use.

Now, a large study in the Journal of the American Geriatrics Society including more than 40,000 individuals with atrial fibrillation who were followed for at least five years has found that catheter ablation is indeed linked to lower risks of these outcomes in all types of patients.

In the study, the risk of dementia was on average approximately 48% lower in patients who underwent catheter ablation compared with those who did not. The catheter ablation group also had a lower risk of death from any cause. These associations remained in subgroup analyses in individuals aged 65–79 years; aged ≥80 years; males; females; participants who received oral anticoagulant medications during follow-up; participants with different types of atrial fibrillation; and participants with and without hypertension, diabetes, ischemic stroke, chronic kidney disease, and heart failure.

"The association between atrial fibrillation and higher risk of dementia is important, and strategies to lower this risk deserve attention. In our large study people with atrial fibrillation had a lower risk of dementia if they had catheter ablation, and this was upheld irrespective of age, sex, and other health conditions," said corresponding author Stephanie Harrison, BSc (Hons), MSc, Ph.D., of the University of Liverpool. "This could be an important consideration when determining appropriate treatment options for patients with atrial fibrillation."