AF Ablation and the Brain: Does It Improve Blood Flow and Cognition? | JACC Baran

Hosts Mitsuaki Sawano, MD, Satoshi Shoji, MD, Nobuhiro Ikemura, MD, and Hiroyuki Sato, MD welcome Dr. Tasuku Yamamoto, MD (Cleveland Clinic) to discuss his JACC: Clinical Electrophysiology study, “Neurocognitive Function, Cerebral Blood Flow, and Hippocampal Volume After Catheter Ablation of Atrial Fibrillation.” Using detailed digital cognitive testing with CANTAB alongside brain MRI in a prospective cohort, the study explores whether AF ablation is associated with changes in cognition, cerebral blood flow, and hippocampal volume. While the primary cognitive endpoints were neutral, ablation was linked to increased cerebral blood flow and greater hippocampal volume change—both correlating with improvements in memory-related measures. This episode delves into the mechanistic implications, highlighting how AF-related cognitive decline may extend beyond overt stroke, and how rhythm control, brain perfusion, and antiarrhythmic drug exposure may collectively shape long-term neurocognitive outcomes.