Catheter ablation reduces dementia risk in A-Fib, heart disease patients more than medications

March 16, 2019

Even though most medical practitioners may opt not to perform procedures on higher-risk patients, new research finds that it may be a good idea for those who suffer from both atrial fibrillation and heart disease.

In a new study from the Intermountain Healthcare Heart Institute in Salt Lake City, researchers found that performing catheter ablations on patients who suffer from both atrial fibrillation and carotid arterial disease reduces their risk of dementia and stroke compared to managing their care with medications.

Catheter ablation is a procedure that makes small scars in heart tissue to prevent abnormal electrical signals from causing rapid and irregular heart rhythms, or atrial fibrillation.

The findings could lead to changes in how patients with atrial fibrillation and carotid arterial disease are treated, even if they traditionally haven't been candidates for more aggressive treatment, such as an ablation.

"Often in medicine, higher-risk patients are less often referred for an invasive procedure due to concerns of procedural risk," said T. Jared Bunch, MD, principal investigator of the study and medical director of Heart Rhythm Services for Intermountain Healthcare. "Our research shows that higher risk patients may be those who are most likely to benefit from ablation when the procedure can be performed safely in centers with expertise so that these patients' long-term risk of dementia and stroke can be positively impacted."

Results of the study were presented at the American College of Cardiology Scientific Sessions in Atlanta on March 16.

"Atrial fibrillation and dementia are two disease states that are becoming more common in our society and are placing an increasing burden on patients, families, and the healthcare system," Dr. Bunch.

"The results of our study raise the awareness of the significant connection between the two and show what a significant difference catheter ablation can make as we understand the potential benefits of restoring a normal heart rhythm to improve brain health."

In the study, researchers identified 5,786 atrial fibrillation patients with no history of dementia. Patients were then separated into those who had carotid arterial disease, and those who didn't.

Researchers found that performing catheter ablation to correct irregular heartbeats in patients with both atrial fibrillation and carotid arterial disease resulted in a lower five-year risk of dementia or stroke and dementia alone, compared to similar patients who didn't have the procedure done. They also found that ablation made less of a difference in patients with just atrial fibrillation.

"We have previously shown the both atrial fibrillation and carotid arterial disease can increase risk of both stroke and dementia, the next step was to understand how treatments may impact risks," added Dr. Bunch.

Dr. Bunch believes that atrial fibrillation, which is an irregular heartbeat that leads to interrupted blood flow to the brain, is compounded by carotid arterial disease, in which plaque builds up in the carotid arteries. That's because when an artery is blocked, the brain loses some of its ability to compensate for hemodynamic stress that can occur with abnormal heart rhythms and as a consequence brain injury and dysfunction can develop.

"There's not a known therapy that changes the natural progressive course of dementia. Dementia now is one of the most common causes of disability and death in developed countries. As a consequence, we have to identify people at risk of dementia earlier before they come into the clinic with cognitive decline to start potential disease altering therapies very early," said Dr. Bunch.

"Without treatments that can improve dementia progression, our efforts need to center on prevention within the multiple pathways that cause brain injury and dysfunction."
-end-
Study funding was provided, in part, by donors to the Intermountain Research and Medical Foundation.

Intermountain Medical Center

Related Dementia Articles from Brightsurf:

The danger of Z-drugs for dementia patients
Strong sleeping pills known as 'Z-drugs' are linked with an increased risk of falls, fractures and stroke among people with dementia, according to new research.

The long road to dementia
Alzheimer's disease develops over decades. It begins with a fatal chain reaction in which masses of misfolded beta-amyloid proteins are produced that in the end literally flood the brain.

Why people with dementia go missing
People with dementia are more likely to go missing in areas where road networks are dense, complicated and disordered - according to new research from the University of East Anglia.

PTSD may double risk of dementia
People who have experienced post-traumatic stress disorder (PTSD) are up to twice as likely to develop dementia later in life, according to a new study by UCL researchers, published in the British Journal of Psychiatry.

Dementia education
School-based dementia education could deliver much needed empathy and understanding for older generations as new research from the University of South Australia shows it can significantly improve dementia knowledge and awareness among younger generations.

Building dementia friendly churches
A project to help church communities become more 'dementia friendly' has had a significant impact across the country.

A "feeling" for dementia?
A research team led by the DZNE concludes that personal perception can be an important indicator for the early detection of Alzheimer's disease.

New biomarker for dementia diagnosis
Medical researchers in the UK and Australia have identified a new marker which could support the search for novel preventative and therapeutic treatments for dementia.

Digital solutions for dementia care
Telehealth delivery of dementia care in the home can be as effective as face-to-face home visit services if carers and recipients take advantage of the technologies available, Australian researchers say.

Despite a marked reduction in the prevalence of dementia, the number of people with dementia is set to double by 2050 according to new Alzheimer Europe report
Today, at a European Parliament lunch debate, Alzheimer Europe launched a new report presenting the findings of its collaborative analysis of recent prevalence studies and setting out updated prevalence rates for dementia in Europe.

Read More: Dementia News and Dementia Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.