The Lead Episode 145: Heart Rhythm 2026 Late Breaker Coverage: A Discussion of Cognitive Function and Anticoagulation Discontinuation in Patients Without Long-Term Recurrence After Catheter Ablation for Atrial Fibrillation-The Lead Episode 145 Bonus Video

Video Transcription

Video Summary

This HRS podcast discussed a late-breaking substudy from the LONE AF trial on cognition after atrial fibrillation ablation. Patients free of arrhythmia at one year were randomized to continue or stop anticoagulation, with MoCA cognitive testing at follow-up. Experts noted no cognitive benefit from continuing anticoagulation, but more bleeding, while stopping anticoagulation did not worsen outcomes. Strengths included nearly 800 patients and paired MoCA scores. Limitations were the absence of a true pre-ablation baseline, low stroke rates, and only 24 months of follow-up. The panel emphasized the need for larger trials, MRI biomarkers, and better cognitive endpoints in AF research.

Keywords

atrial fibrillation ablation

anticoagulation

cognitive outcomes

MoCA testing

LONE AF trial