Ablation and dementia risk

[tcpace]

Something I wasn't previously aware of is that catheter ablation raises the risk of developing dementia (see article below). Fortunately, warfarin and oral anti-coagulants offset that risk significantly so, after an ablation, it's wise not to think in terms of trying to get off them. My wife once tried to but her EP was extremely insistent that she shouldn't but didn't say why. Maybe he had the dementia risk in mind.

escardio.org/The-ESC/Press-...

[BobD Volunteer]

I thought this was well understood. Most EPs now perform ablation whilst the patient is anticoagulated to minimise any micro embolii wich may form during the precedure, It is these thought to cause a measure of vascular dementia,

The continuation of anticoagulants post ablation is actually more about contnued stroke prevention as there is no evidence that ablation removes stroke risk. Some people with low or zero Chadsvasc scores may be able to stop if anticoaguoants were only started for the purpose of the ablation but most of us look on them as our best friend..

[karim123 in reply to BobD]

You always there for us the. Karim

[Hidden]

Wouldn't this apply to any such procedure or operation? Why would it be specifically to do with ablations?

[tcpace in reply to Hidden]

Probably but how many other surgical procedures would involve taking Warfarin or an anti-coag subsequently? The thrust of the article is that RF ablation increases dementia risk but anti-coagulants offset that risk - hence a good reason to continue taking them even if your Chadvasc score might suggest you could stop taking them.

[MarkS in reply to Hidden]

There appears to be an extra risk with ablations because the catheter tends to produce clouds of particles when it is heating the heart muscle. Also the left atrium pumps blood to the left ventricle where it then goes round the body with a direct line to the brain. That is why it is essential to continue anti-coagulation throughout ablations and not stop on the morning or use heparin bridging as some EPs still do.

[BobD Volunteer in reply to Hidden]

Not really. The actual burns can cause small amounts of debris to form I understand which the anticoagulant reduces.

[Globe-J]

Thank you for a link to an interesting article

J (-:

[Kevin51]

Puzzled! Followed the link to "Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: data from a population-based cohort ". No mention anywhere of CA. Their conclusion states "Limitations ... Third, we did not have information regarding treatment following AF. It is possible that the risk of dementia in patients with AF may be attenuated after successful treatment. "