Project Details
Projekt
Catheter Ablation for Rhythm Control and The Impact on Cerebral Blood Flow, structural and functional brain connectivity and cognitive performance in patients with persistent Atrial Fibrillation (ARCTIC-CBF)
Subject Area
Clinical Neurology; Neurosurgery and Neuroradiology
Term
since 2024
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 530992044
The published data on atrial fibrillation (AF), brain perfusion and brain biomarkers suggests an association between AF, structural brain damage, reduced brain function, and cognitive decline. There is, however, little data on the impact of AF on cerebral perfusion and functional/structural brain connectivity as well as markers of integrity of the blood brain barrier (BBB), that are all being considered contributing factors to the development of cognitive impairment and its progression to dementia. The overarching aim of this project is to quantify above named factors by brain MRI and biomarkers, cardiac structure and function quantified by cardiac MRI and biomarkers, and tests of cognitive function and characterize their interactions. To this end, we will study patients with persistent AF before and twice after clinically indicated catheter ablation. We hypothesize that during AF, cerebral blood flow and perfusion are decreased, presenting a negative effect on functional and structural brain connectivity as well as cognitive function. Furthermore, we hypothesize that during AF peripheral biomarkers of chronic cerebral injury as well as NT pro-BNP are elevated in peripheral serum. We also hypothesize that parameters of brain perfusion, structural and functional brain connectivity, and cognition will normalize after successful conversion to sinus rhythm after catherter ablation, associated with improved cardiac function. As approximately 1/3 of patients will experience recurrent AF after ablation, we will be able to compare cognitive function, brain and cardiac imaging, and biomarkers of cardiac and brain function in patients with recurrent AF compared to those remaining in sinus rhythm throughout the study. We will enrol adult patients with symptomatic persistent AF undergoing catheter ablation. We will exclude patients with previous stroke, established dementia or contraindications for any of the planned examinations (e.g. MRI). We will also exclude patients with a reduction of left ventricular ejection fraction (<50%) since a reduced cardiac output volume has been proven to reduce cerebral perfusion independent of heart rhythm. The planned sample size is 80 patients. The project will foster a better understanding of the interactions between AF, cerebral perfusion, structural and functional brain connectivity, integrity of the BBB, and cognitive function and thus provide insights towards improved possibilities of early detection and prevention of cognitive impairment and dementia which may inform better patient care and targeted preventive interventions.
DFG Programme
Research Grants
