Cognitive outcomes post-catheter ablation for atrial fibrillation: a systematic review and meta-analysis

Funding Acknowledgements

Type of funding sources: None.

Background

Atrial fibrillation (AF) is a known risk factor for cognitive impairment and dementia. Recent data suggests that successful restoration of sinus rhythm by catheter ablation improves cognitive outcomes. Purpose: Our aim was to perform a systematic review and meta-analysis of the available data regarding the effectiveness of AF catheter ablation on neurocognitive outcomes. Methods: A comprehensive literature search was performed through December 1, 2020, for all eligible studies comparing neurocognitive outcomes in AF patients with or without AF catheter ablation. Clinical outcomes included rate of dementia, cognitive function by Montreal Cognitive Assessment (MOCA) and Mini-Mental State Examination (MMSE) scores. Additional outcomes included the impact of time in sinus rhythm on neurocognitive outcomes. Results: We identified 11 studies which evaluated the effect of AF catheter ablation on dementia rate, MMSE and MOCA score. Meta-analysis of observational results indicates a decreased risk of dementia (risk ratio 0.51; 95% CI: 0.43 to 0.60; p <0.001) and an improvement in MOCA scores (2.92 points, p < 0.001) but not MMSE scores in patients undergoing AF catheter ablation compared to medical therapy. In addition, the maintenance of sinus rhythm was identified as a significant factor in dementia rate and improvement of MMSE and MOCA scores observed post catheter ablation therapy. Conclusion: AF catheter ablation may reduce the incidence of dementia and improve cognitive function. A large-scale randomized control trial is warranted before recommendations can be made regarding AF ablation and cognitive outcomes. Abstract Figure.

Preparation and characterization of the lateral and basal plasma membranes of the rat intestinal epithelial cell

A technique is described for the isolation of a plasma-membrane fraction from the rat intestinal epithelial cell which is distinct from the microvillus membrane of that cell. The isolated fraction contains only about 0.2% of the sucrase activity in the original homogenate and negligible quantities of nuclear and mitochondrial membrane markers. It contains 12% of the total Na(+),K(+)-dependent adenosine triphosphatase and 7% of the alkaline phosphatase, with significant increments in specific activity of these enzymes. Multiple membrane preparations were highly reproducible with respect to the specific activities of the markers studied. The small intestine of one rat yields material containing about 1.3mg of protein. In addition an assay is described suitable for determining 5'-nucleotidase in the small intestine.