Association Between Catheter Ablation and Dementia Among Patients With Atrial Fibrillation: A Meta-Analysis

Background: Atrial fibrillation (AF) has been found to be associated with an increased risk of dementia. However, catheter ablation (CA) for AF might reduce the risk of dementia is unclear, with conflicting results till date. Objective: We aimed to evaluate the association between CA among AF patients and the incidence of Dementia. Methods: We performed a systematic literature search using the PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until 10th May 2023. Hazard ratios (HR) were pooled using a random-effect model, and a p-value of <0.05 was considered statistically significant. Results: A total of 6 studies with 146709 patients (47040 in the AFCA group and 99669 in the non-CA group) were included in the study. The mean age of patients among CA and non-CA groups was comparable (58.7 vs. 58.18). The most common comorbidity among CA and non-CA groups was hypertension (30.30% vs.67.70%), respectively. Pooled analysis of primary outcome showed that CA significantly reduced the incidence of dementia (HR, 0.63(95%CI: 0.52-0.77), P<0.001). Similarly, pooled analysis of secondary outcomes showed that the CA group of patients were having significantly reduced incidence of alzheimer's disease (HR, 0.78(95%CI: 0.66-0.92), P<0.001) compared with the non-CA group. However, a non-statistically significant lower incidence of vascular dementia was observed in the AFCA group (HR, 0.63(95%CI: 0.38-1.06), P=0.08) compared with the non-CA group. Conclusion: Catheter ablation reduced the risk of dementia and alzheimer’s disease compared with the non-ablation group of patients.