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AF linked to reduced brain volume and cognitive function

Atrial fibrillation (AF) has a cumulative negative effect on the brain independent of cerebral infarcts, according to a study1 published recently in Stroke which finds it is associated with smaller brain volume, and the association is stronger with increasing burden of the arrhythmia.

Researchers analysed 4,251 non-demented participants (mean age, 76±5 years) in the population-based Age, Gene/Environment Susceptibility (AGES) Reykjavik Study. Medical record data were collected for the presence, subtype, and time from first diagnosis of AF; 330 participants had AF.

Brain volume measurements, adjusted for intracranial volume, and presence of cerebral infarcts were determined with magnetic resonance imaging. Memory, speed of processing, and executive function composites were calculated from a cognitive test battery. In a multivariable linear regression model, adjustments were made for demographic factors, cardiovascular risk factors, and cerebral infarcts.

Participants with AF had lower total brain volume compared with those without AF (p<0.001). The association was stronger with persistent/permanent than paroxysmal AF and with increased time from the first diagnosis of the disease. Of the brain tissue volumes, AF was associated with lower volume of gray and white matter hyperintensities (p<0.001 and p=0.008, respectively), but not of white matter hyperintensities (p=0.49). Participants with AF scored lower on tests of memory.

For more on cognitive impairment and AF, see ‘Mild cognitive impairment common in AF patients’


1. Stefansdottir H, Arnar DO, Aspelund T, et al. Atrial fibrillation is associated with reduced brain volume and cognitive function independent of cerebral infarcts. Stroke 2013;44:1020–5.​STROKEAHA.12.679381

Published on: March 27, 2013

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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