Impact of catheter ablation versus medical therapy on cognitive function in atrial fibrillation: a systematic review.
Impact of catheter ablation versus medical therapy on cognitive function in atrial fibrillation: a systematic review.
复制标题
DOI：
10.1007/s10840-022-01196-y
复制
发表时间：
2022-10
影响因子：
1.8
通讯作者：
Williams, Steven E.
中科院分区：
文献类型：
--
作者：
Bodagh, Neil;Yap, Reuben;Kotadia, Irum;Sim, Iain;Bhalla, Ajay;Somerville, Peter;O'Neill, Mark;Williams, Steven E.
房颤与认知功能障碍的风险增加有关。目前尚不清楚导管消融术恢复窦性心律是否可以改变这种风险。我们对房颤患者导管消融术与药物治疗（频率和/或节律控制）后认知结局的比较研究进行了系统综述。从开始到2021年10月17日，对以下数据库进行了检索：PubMed、奥维德Medline、Embase和科克伦图书馆。入选标准包括比较导管消融与药物治疗（心率和/或节律控制，适当时联合抗凝）的研究，其中包括认知评估和/或痴呆诊断作为结局。共筛选了599份记录。纳入了10项研究，包括15，886例接受导管消融治疗的患者和42，684例接受药物治疗的患者。比较导管消融与药物治疗对认知功能定量评估的影响的研究得出了相互矛盾的结果。在随访期间检查新发痴呆的研究中，与药物治疗相比，导管消融术与后续痴呆诊断的风险较低相关（风险比：0.60（95%置信区间0.42-0.88，p < 0.05））。越来越多的证据表明房颤与认知功能障碍有关，因此需要设计旨在最大限度地减少认知功能下降的房颤治疗策略。然而，导管消融术和房颤药物治疗对认知能力下降的影响目前尚不确定。未来研究房颤治疗策略应包括认知结果作为重要的临床终点。在线版本包含补充材料，可通过10.1007/s10840-022-01196-y获得。
Atrial fibrillation is associated with an increased risk of cognitive impairment. It is unclear whether the restoration of sinus rhythm with catheter ablation may modify this risk. We conducted a systematic review of studies comparing cognitive outcomes following catheter ablation with medical therapy (rate and/or rhythm control) in atrial fibrillation. Searches were performed on the following databases from their inception to 17 October 2021: PubMed, OVID Medline, Embase and Cochrane Library. The inclusion criteria comprised studies comparing catheter ablation against medical therapy (rate and/or rhythm control in conjunction with anticoagulation where appropriate) which included cognitive assessment and/or a diagnosis of dementia as an outcome. A total of 599 records were screened. Ten studies including 15,886 patients treated with catheter ablation and 42,684 patients treated with medical therapy were included. Studies which compared the impact of catheter ablation versus medical therapy on quantitative assessments of cognitive function yielded conflicting results. In studies, examining new onset dementia during follow-up, catheter ablation was associated with a lower risk of subsequent dementia diagnosis compared to medical therapy (hazard ratio: 0.60 (95% confidence interval 0.42–0.88, p < 0.05)). The accumulating evidence linking atrial fibrillation with cognitive impairment warrants the design of atrial fibrillation treatment strategies aimed at minimising cognitive decline. However, the impact of catheter ablation and atrial fibrillation medical therapy on cognitive decline is currently uncertain. Future studies investigating atrial fibrillation treatment strategies should include cognitive outcomes as important clinical endpoints. The online version contains supplementary material available at 10.1007/s10840-022-01196-y.
登录
查看更多内容
影响因子：
39.3
作者：
Kirchhof P;Haeusler KG;Blank B;De Bono J;Callans D;Elvan A;Fetsch T;Van Gelder IC;Gentlesk P;Grimaldi M;Hansen J;Hindricks G;Al-Khalidi HR;Massaro T;Mont L;Nielsen JC;Nölker G;Piccini JP;De Potter T;Scherr D;Schotten U;Themistoclakis S;Todd D;Vijgen J;Di Biase L
通讯作者：
Di Biase L
影响因子：
8.3
作者：
Sigurdsson S;Aspelund T;Kjartansson O;Gudmundsson EF;Jonsdottir MK;Eiriksdottir G;Jonsson PV;van Buchem MA;Gudnason V;Launer LJ
通讯作者：
Launer LJ
DOI：
10.1136/heartjnl-2020-316612
发表时间：
2020-12
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Piccini JP;Todd DM;Massaro T;Lougee A;Haeusler KG;Blank B;de Bono JP;Callans DJ;Elvan A;Fetsch T;Van Gelder I;Gentlesk P;Grimaldi M;Hansen J;Hindricks G;Al-Khalidi H;Mont L;Nielsen JC;Noelker G;De Potter T;Scherr D;Schotten U;Themistoclakis S;Vijgen J;Di Biase L;Kirchhof P
通讯作者：
Kirchhof P
影响因子：
4.6
作者：
Kato N;Muraga K;Hirata Y;Shindo A;Matsuura K;Ii Y;Shiga M;Tabei KI;Satoh M;Fujita S;Fukuma T;Kagawa Y;Fujii E;Umino M;Maeda M;Sakuma H;Ito M;Tomimoto H
通讯作者：
Tomimoto H
影响因子：
5.5
作者：
Schwarz, Niko;Kuniss, Malte;Gerriets, Tibo
通讯作者：
Gerriets, Tibo