Stopping Atrial Fibrillation Could Reduce the Risk of Stroke and Alzheimer’s Disease

June 10, 2010 7:05 AM CT

By Peggy Noonan and Mellanie True Hills

Findings presented at Heart Rhythm 2010, the 31st Annual Scientific Sessions of the Heart Rhythm Society in Denver, Colorado, showed that catheter ablation treatment for atrial fibrillation could reduce the risk of developing Alzheimer’s disease and other dementias and reduce the risk of stroke and death.

Doctors used data gathered over a three-year period from 37,908 people who were enrolled in a large, ongoing prospective study at Intermountain Medical Center in Salt Lake City, Utah, to evaluate the long-term effects of catheter ablation treatment for people who had atrial fibrillation.

Participants in the study were divided into three age- and gender-matched groups:

  • People with atrial fibrillation who were treated with catheter ablation
  • People with atrial fibrillation who were treated with medications only
  • People who did not have atrial fibrillation

Study leaders John D. Day, MD, and T. Jared Bunch, MD, from the Heart Institute at Intermountain Medical Center, report that after three years, 64% of people who had atrial fibrillation ablations were free of afib and off antiarrhythmic drugs, and when compared to patients on medications only, they experienced significant reductions in the occurrence of Alzheimer’s disease and strokes. Here are some of those differences:

  • Alzheimer’s disease: 0.2% of those who had AF ablations vs. 0.9% of those on medications only
  • Dementia: 0.4% of those who had AF ablations vs. 1.9% of those on medications only
  • Strokes: 2.2% of those who had AF ablations vs.  4.7% of those on medications only
  • Stroke deaths: 6% of those who had AF ablations vs. 23.5% of those on medications only

“Our studies shed light on the positive outcomes of catheter ablation treatment not only to reduce AF,” Dr. Day said, “but also to help AF patients lower their risk of developing Alzheimer’s disease, suffering from a stroke or worse, loss of life.”

These findings were presented in sessions titled “Catheter Ablation of Atrial Fibrillation Reduces the Risk of Alzheimer’s Disease and Dementia” and “Atrial Fibrillation Ablation Significantly Reduces Long-term Mortality and Strokes in a Large Patient Population.”

To learn more about Heart Rhythm 2010 and the research presented at the conference, see:

Mellanie’s comments:

The results of these studies have been somewhat controversial in the electrophysiology (EP) community, for good reasons. Here’s one example, Do hundreds of left atrial burns reduce dementia risk?, from Dr. John Mandrola, EP.

However, if the trends in these early studies are also shown in further studies, then eliminating atrial fibrillation could potentially help stop what appears to be an unavoidable journey of afib patients towards Alzheimer’s disease.

Catheter ablation is just one of many ways to put the heart into normal sinus rhythm and keep it there; medications and surgery can do the same. If this is proven, then it makes sense that being in rhythm is likely to be significantly better than staying in afib. Thus that may lead us to question such strategies as rate control and AV node ablation if they result in leaving the patient in afib long term.

Hopefully the “let’s just wait and see” approach to afib will go away. Afib rarely gets better, and generally gets worse, so let’s do something while we still can!

Peggy Noonan specializes in writing about health for consumers and medical professionals. She writes for leading national magazines and consumer publications as well as StopAfib.org.

Mellanie True Hills is founder and CEO of StopAfib.org and an atrial fibrillation survivor.