Cognitive Impairment Associated With Atrial Fibrillation
Authors: David A. Nardone
Journal: Annals of Internal Medicine (2013)

Letters4 June 2013Cognitive Impairment Associated With Atrial FibrillationDavid A. Nardone, MDDavid A. Nardone, MDFrom Hillsboro, Oregon.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-11-201306040-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Kalantarian and colleagues' recent meta-analysis (1) showed that atrial fibrillation (AF) predicts cognitive impairment and dementia and that further study is recommended to clarify any association between AF and subtypes of dementia. I agree with their conclusion but suggest an equal focus on assessing any difference in the risk for cognitive decline according to 3 AF subtypes: paroxysmal, persistent, and permanent.Several studies support the value of AF categorization. Patients with subclinical AF of longer duration may have a higher incidence of stroke (2). Atrial fibrillation burden (≤5 minutes per day, >5 minutes but <24 hours per ...References1. Kalantarian S, Stern TA, Mansour M, Ruskin JN. Cognitive impairment associated with atrial fibrillation: a meta-analysis. Ann Intern Med. 2013;158:338-46. [PMID: 23460057] LinkGoogle Scholar2. Healey JS, Connolly SJ, Gold MR, Israel CW, Van Gelder IC, Capucci A, et al; ASSERT Investigators. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med. 2012;366:120-9. [PMID: 22236222] CrossrefMedlineGoogle Scholar3. Boriani G, Botto GL, Padeletti L, Santini M, Capucci A, Gulizia M, et al; Italian AT-500 Registry Investigators. Improving stroke risk stratification using the CHADS2 and CHA2DS2-VASc risk scores in patients with paroxysmal atrial fibrillation by continuous arrhythmia burden monitoring. Stroke. 2011;42:1768-70. [PMID: 21493904] CrossrefMedlineGoogle Scholar4. Stefansdottir H, Arnar DO, Aspelund T, Sigurdsson S, Jonsdottir MK, Hjaltason H, et al. Atrial fibrillation is associated with reduced brain volume and cognitive function independent of cerebral infarcts. Stroke. 2013;44:1020-5. [PMID: 23444303] CrossrefMedlineGoogle Scholar5. Naess H, Waje-Andreassen U, Thomassen L. Persistent atrial fibrillation is associated with worse prognosis than paroxysmal atrial fibrillation in acute cerebral infarction. ISRN Cardiol. 2012;2012:650915. [PMID: 23056960] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: David A. Nardone, MDAffiliations: From Hillsboro, Oregon.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCognitive Impairment Associated With Atrial Fibrillation Shadi Kalantarian , Theodore A. Stern , Moussa Mansour , and Jeremy N. Ruskin Cognitive Impairment Associated With Atrial Fibrillation Shadi Kalantarian and Jeremy N. Ruskin Metrics Cited byAtrial Fibrillation Catheter Ablation Improves 1-Year Follow-Up Cognitive Function, Especially in Patients With Impaired Cognitive Function 4 June 2013Volume 158, Issue 11Page: 849KeywordsAtrial fibrillationBrainCaregiversCognitive impairmentConflicts of interestDementiaInfarctionStrokeThromboembolism ePublished: 4 June 2013 Issue Published: 4 June 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...