Association of cardiac rhythm with cognitive performance in atrial fibrillation patients

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: Foundation. Main funding source(s): Swiss National Science Foundation, Swiss Heart Foundation, BACKGROUND: Atrial fibrillation (AF) is strongly associated with an increased risk of cognitive decline and dementia. AF-induced cerebral hypoperfusion, caused by loss of atrial contraction and RR interval variation, is discussed as one possible underlying mechanism. However, the short-term association between heart rhythm and cognitive performance is not clear. Here, we aimed to investigate the association of rhythm (AF vs. sinus rhythm, SR) with cognitive performance in AF patients. METHODS: We enrolled patients from a prospective, multicenter cohort study. At study visits, patients underwent 5-minute resting ECG recordings and extensive cognitive testing including the Montreal Cognitive Assessment (MoCA) and cognitive construct score (CoCo). Multivariable adjusted mixed effect linear regression models were used to investigate the association between acute heart rhythm on ECG (AF vs. SR) and cognitive performance. Further, we investigated the association between heart rhythm and the Geriatric Depression Score (GDS) as well as the European Quality of Life Visual Analogue Scale (EQ-VAS 100). RESULTS: 5206 ECGs from 1648 AF patients were available for analysis. 46% of ECGs were in AF. Mean age of the patients was 72 years and 27% were females. After adjustment for pre-defined covariables, we did not identify an independent association between heart rhythm (AF vs. SR) and cognitive performance in any test. However, patients with present AF on ECG had reported worse GDS and EQ-VAS 100 scores. CONCLUSION: In our large cohort of AF patients, there was no acute association between heart rhythm (AF or SR) and cognitive performance.