Staying in A-Fib Reduces Brain Volume & Cognitive Function
A study of brain atrophy from Iceland found that A-Fib in the elderly caused accelerated loses of brain volume and cognitive function.
This is yet another study driving a stake into the heart of the notion that you can just leave patients in A-Fib with anticoagulants and rate control drugs, and they will live happily ever after.
“It’s better for the brain to remain in sinus rhythm than to pursue rate control of A-Fib” stated Dr. David O. Arnar, speaking of the AGES-Reykjavik Study results at the 2015 Euro Society of Cardiology Annual Congress.
The AGES-Reykjavik Study
Over two thousand elderly subjects without dementia (mean age 67 years old) were tested and followed for over 5 years. Participants had brain MRIs and structured cognitive function testing during the duration of the study.
The 2,472 elderly patients fell into three groups: those who remained A-Fib-free throughout the study, those with confirmed A-Fib at the start (121), and those who developed new-onset A-Fib (132) by the end of the study.
AGES Findings: Brain Matter
At the end of the follow-up period, all participants had a reduction in brain grey matter. The amount of reduction varied significantly by group:
• A-Fib-free: 1.8% decrease
• Ongoing A-Fib: 2.79% decrease
• New-onset A-Fib: 6.5% decrease
Loss of brain white matter and the development of white matter brain lesions showed similar results.
AGES Findings: Cognitive Function
Testing cognitive function, processing speed declined over time for all groups:
• A-Fib-free: 10 % decrease
• Ongoing A-Fib: 12.7% decrease
• New-onset A-Fib: 13.9 % decrease
Similar results were found when measuring executive function and memory.
Dr. Arnar was surprised that the changes in processing speed were more pronounced in those with new-onset A-Fib compared to those with ongoing A-Fib. He speculated that patients may adapt to being in A-Fib, so that the rate of change in the brain becomes less pronounced as the A-Fib becomes chronic.
A-Fib Reduces Cerebral Blood Flow: A Key to Brain Deterioration and Aging?
The mechanism by which A-Fib accelerates brain aging is unknown. But Dr. Arnar suspects it’s “…most assuredly AF-induced diminution of cerebral blood flow.”
He showed how the A-Fib-free participants averaged total cerebral blood flow of 540 mL/min, while subjects with A-Fib averaged a lower 480 mL/min.
Improve Cerebral Blood Flow with Electrocardioversion
In another study, Dr. Arnar described preliminary results from an ongoing brain perfusion imaging study conducted with 17 AF patients before and after Electrocardioversion. After restoring sinus rhythm, cerebral blood flow was significantly improved and lasted for 10 weeks.
Their total cerebral blood flow improved by a mean of 70 mL/min. Both their grey and white brain matter perfusion improved by 10%.
What Patients Need to Know
When viewing today’s media, be very, very cynical. Remember: almost everything you see about A-Fib in the media is controlled or influenced by drug companies.
Don’t settle for a life on meds: Today’s advertisements for anticoagulants show people living happy, healthy lives while still in A-Fib. But this isn’t usually true.
Along with a host of other problems, living in Atrial Fibrillation causes brain damage and a loss of cognitive function.
Dr. Arnar’s study shows that over time, living in A-Fib (on drug therapy) will most likely damage your brain and impair your thinking ability.
Get a second opinion: If your doctor only prescribes medication (an anticoagulant and perhaps a rate control drug), it’s time to get a second opinion. Look for a doctor (preferably an electrophysiologist who specializes in heart rhythm problems) to get you back into sinus rhythm. A-Fib can be cured by procedures like a catheter ablation.
Contrary to what you hear in the media: Aim to be A-Fib-free!