Cognition improved after ablation?

[MarkS]

This is an interesting article. It's actually headed "Cognitive Problems Transient After AF Ablation". The main finding is that there is a temporary dip in cognition for 3m after an ablation - presumably due to the stress following an ablation.

However, by 12m, 14% of the ablation arm actually showed improvement in cognition compared with none in the control arm (where they just stayed on anti-arrhythmic drugs):

medscape.com/viewarticle/99...

Presumably this is due to the improved blood flow after a successful ablation.

[BobD Volunteer]

More good news Mark. Thankyou. Need all I can get! lol 😁

[mjames1]

This is one of those studies that definitely needs more follow up before drawing any definite conclusions. Unfortunately, I have seen it recently being used to promote catheter ablation, i.e "ablation prevents dementia".

My first reaction, was that it must be the anesthesia which caused the temporary cognitive decline in the ablation group. Further backed by the longer the procedure, the more the decline. I also wish they detailed the type of anesthesia used and what medications the ablation group was on pre and post ablation.

The better cognitive testing scores could simply be a result of less medications in the ablation group post ablation and nothing to do with ablation improving cognitive function.

Jim

[MarkS in reply to mjames1]

Agreed, the 12m boost to cognition could be down to less medication. But in my book that's a definite plus. No more zombie feelings from beta blockers. And as for amiodarone which actually increases mortality...

[mjames1 in reply to MarkS]

Yes but it also raises the issue of over medication such as daily beta blockers when not in afib. You don't need an ablation in many cases to reduce meds.

Jim

[Popepaul]

I think that Mjames above gives a rational interpretation of this study. A good percentage of older people who undergo surgery experience a degree of cognitive decline. This is sometimes accompanied by delerium More often than not the decline is temporary and occasionally longer term. The concept of Compromised brain is often used to explain the phenomenon. A history of trauma, serious infections, alcohol and drug addiction, chronic poor sleep etc are the usual correlates.

Reduced usage of medications a year after ablation may be a reasonable explaination for improved cognition.

[waveylines]

I would guess this is more likely to do with the cessation of beta blockers post surgery. Beta blocker work by reducing the conversion of Thyroid hormones T4, to T3. T3 is the useable form and is needed for functioning in all parts of the body. T3 is higher in the brain so stopping the beta blockers would increase the T3 levels back up to normal thereby helping the brain to function more effectively.

ncbi.nlm.nih.gov/books/NBK2...

[wilsond]

My sons both say I am more 'with it' 13m on from mine,interesting article. I am still on all meds at the moment.

[Letofeyd]

I think this is a case of "Correlation is not causation".😏 There are a lot of other possible factors in the improved cognition. More specific investigation is needed.