Atrial fibrillation, the most common of cardiac arrhythmias, would be responsible for cognitive decline and dementia, even in the absence of obvious clinical events, such as the classic cerebral stroke. It is the result of a study just published on EUROPAC, the international scientific journal of cardiac arrhythmology. The research was conducted by a multidisciplinary group made up of cardiologists and researchers from the Molinette hospital of the City of Health and the University of Turin and made it possible to study for the first time in humans the effects exerted by atrial fibrillation on blood flow in small cerebral vessels. Through the use of a method known as near infrared spectroscopy (NIRS), in fact, small probes applied to the skin of the patient’s forehead allow to obtain information on the blood flow in the brain.
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The studies were carried out on about 50 patients with atrial fibrillation afferent to the University Cardiology of the Molinette hospital and allowed to demonstrate how in the course of arrhythmia transient but repeated alterations of the flow in the cerebral microcirculation are generated. “We believe that these transient critical reductions in the blood supply to the brain contribute in the long term to the genesis of dementia and more generally to the cognitive deficit associated with atrial fibrillation,” explains Gaetana Maria De Ferrari, director of Turin Cardiology.
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It is important to highlight how the alterations in cerebral circulation recorded by NIRS in the course of atrial fibrillation tend to disappear when normal heart rhythm is restored through an electrical cardioversion. “Today we can offer patients with atrial fibrillation a very effective technique in maintaining long-term sinus rhythm, such as catheter ablation – says Matteo Anselmino, who participated in the study – and we therefore plan to evaluate whether with this approach it is possible to reduce cognitive decline in this patient population “.
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Considering that atrial fibrillation increases with increasing age and a doubling of cases is expected by 2050, it is clear how important it was to understand the mechanisms that link atrial fibrillation to dementia, in order to be able to optimize therapeutic strategies. and minimize the cognitive deficit related to the arrhythmia, with enormous potential repercussions on the quality of life and the management of the health and social care of patients. Andrea Saglietto and Daniela Canova and a team of engineers from the Polytechnic of Turin (Luca Ridolfi and Stefania Scarsoglio) also took part in the study.
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