The Impact of Atrial Fibrillation Treatment Strategies on Cognitive Function

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 May 13

PMID 37176490

Authors

Neil Bodagh

Irum Kotadia

Ali Gharaviri

Fernando Zelaya

Jonathan Birns

Ajay Bhalla

Peter Sommerville

Steven Niederer

Mark ONeill

Steven E Williams

Affiliations

Soon will be listed here.

Abstract

There is increasing evidence to suggest that atrial fibrillation is associated with a heightened risk of dementia. The mechanism of interaction is unclear. Atrial fibrillation-induced cerebral infarcts, hypoperfusion, systemic inflammation, and anticoagulant therapy-induced cerebral microbleeds, have been proposed to explain the link between these conditions. An understanding of the pathogenesis of atrial fibrillation-associated cognitive decline may enable the development of treatment strategies targeted towards the prevention of dementia in atrial fibrillation patients. The aim of this review is to explore the impact that existing atrial fibrillation treatment strategies may have on cognition and the putative mechanisms linking the two conditions. This review examines how components of the 'Atrial Fibrillation Better Care pathway' (stroke risk reduction, rhythm control, rate control, and risk factor management) may influence the trajectory of atrial fibrillation-associated cognitive decline. The requirements for further prospective studies to understand the mechanistic link between atrial fibrillation and dementia and to develop treatment strategies targeted towards the prevention of atrial fibrillation-associated cognitive decline, are highlighted.

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