Atrial fibrillation increases beat-to-beat variability of cerebral microcirculatory perfusion – a potential target for reducing long-term cognitive decline?

By Ahmed El-Medany

This pioneering in vivo study by Saglietto et al investigated beat-to-beat microcirculatory perfusion during atrial fibrillation (AF) by using near-infrared spectroscopy to non-invasively monitor cerebral haemodynamics. A proxy of microcirculatory cerebral perfusion was compared before and after restoration of AF to sinus rhythm following DC cardioversion (DCCV).

DCCV was successful in restoring SR in 51 (96%) of 53 enrolled participants. A significant decrease of both hypoperfusive and hyperperfusive/hypertensive microcirculatory events was observed after restoration to sinus rhythm (P < 0.001 and P = 0.041, respectively).

As AF is associated with cognitive decline and dementia, the authors postulate that sinus rhythm maintenance may slow long-term AF related cognitive impairment.

View more at Oxford Academic

Saglietto A, Scarsoglio S, Canova D, Roatta S, Gianotto N, Piccotti A, Franzin S, Gaita F, De Ferrari GM, Ridolfi L, Anselmino M. Increased beat-to-beat variability of cerebral microcirculatory perfusion during atrial fibrillation: a near-infrared spectroscopy study. EP Europace. 2021 Apr 13.