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Open Access 01-01-2022 | Atrial Fibrillation | Original Paper

Cardiac autonomic function and cognitive performance in patients with atrial fibrillation

Authors: Peter Hämmerle, Stefanie Aeschbacher, Anne Springer, Ceylan Eken, Michael Coslovsky, Gilles Dutilh, Giorgio Moschovitis, Nicolas Rodondi, Patricia Chocano, David Conen, Stefan Osswald, Michael Kühne, Christine S. Zuern

Published in: Clinical Research in Cardiology | Issue 1/2022

Abstract

Background

Atrial fibrillation (AF) is associated with loss of cognition and dementia. Cardiac autonomic dysfunction has been linked to cognitive decline. We aimed to investigate if reduced cardiac autonomic function (CAF) is associated with cognitive impairment in AF patients.

Methods

Patients with paroxysmal, persistent and permanent AF were enrolled from a multicenter cohort study if they had AF (“AF group”) or sinus rhythm (“SR group”) on a baseline 5 min ECG recording. Parameters quantifying CAF (heart rate variability triangular index (HRVI), mean heart rate (MHR), RMSSD, SDNN, total power and power in the VLF, LF, HF ranges) were calculated. We used the Montreal Cognitive Assessment (MoCA) to assess global cognitive function.

Results

1685 AF patients with a mean age of 73 ± 8 years, 29% females, were included. MoCA score was 24.5 ± 3.2 in the AF group (N = 710 patients) and 25.4 ± 3.2 in the SR group (N = 975 patients). After adjusting for multiple confounders, lower HRVI was associated with lower MoCA scores, both in the SR group [β = 0.049; 95% confidence interval (CI) 0.016–0.081; p = 0.003] and in the AF group (β = 0.068; 95% CI 0.020–0.116; p = 0.006). In the AF group, higher MHR was associated with a poorer performance in the MoCA (β = − 0.008; 95% CI − 0.014 to − 0.002; p = 0.014). We found no convincing evidence of association for other CAF parameters with cognition.

Conclusion

Our data suggest that impaired CAF is associated with worse cognitive performance in patients with AF. Among standard HRV parameters, HRVI might be the most promising ECG index.

Trial registration

ClinicalTrials.gov Identifier: NCT02105844.

Graphic abstract

Available only for authorised users

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Title: Cardiac autonomic function and cognitive performance in patients with atrial fibrillation
Authors: Peter Hämmerle
Stefanie Aeschbacher
Anne Springer
Ceylan Eken
Michael Coslovsky
Gilles Dutilh
Giorgio Moschovitis
Nicolas Rodondi
Patricia Chocano
David Conen
Stefan Osswald
Michael Kühne
Christine S. Zuern
Publication date: 01-01-2022
Publisher: Springer Berlin Heidelberg
Keyword: Atrial Fibrillation
Published in: Clinical Research in Cardiology / Issue 1/2022
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-021-01900-4

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Cardiac autonomic function and cognitive performance in patients with atrial fibrillation

Abstract

Background

Methods

Results

Conclusion

Trial registration

Graphic abstract

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Abstract

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Trial registration

Graphic abstract

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