Atrial Fibrillation Is Associated With an Increased Risk of Dementia

Particularly strong support for a link between atrial fibrillation and dementia can be drawn from the increasing strength of this association and longer duration of atrial fibrillation, according to the authors. Of potential mechanisms to explain this association, the authors cited the hypothesis that atrial fibrillation produces impaired blood flow and cerebral hypoperfusion. They cited experimental work linking this hypoperfusion to neuronal damage, but suggested that more data are needed to confirm clinically relevant effects.

As for prevention of dementia, one published study has linked catheter ablation for atrial fibrillation with a reduced risk of dementia, relative to no treatment, according to the authors. Randomized studies are needed, however, to test whether patients with atrial fibrillation who are successfully restored to sinus rhythm have a reduced risk of dementia, the authors suggested. Based on this study, a trial would be particularly appropriate in patients who develop atrial fibrillation before age 67.

—Ted Bosworth