title: Links between parameters of long-term latent memory and progression from paroxysmal to permanent atrial fibrillation during a five-year observation period. A preliminary study.
abstract: OBJECTIVE
  As cognitive function is the most vulnerable human feature, its impairment may precede the occurrence of symptoms of cardiovascular system disorders, e.g. atrial fibrillation (AF). In this way, cognitive impairment may not only be a complication of AF, but also a marker of its progression. This study aims to test this hypothesis.
  
  
  METHODS
  Of 35 patients with AF, 23 (66%) had paroxysmal and 12 (34%) had permanent arrhythmia at the start of the study. At both the start of the study and after 5.86 ± 3.7-7.05 years of follow-up, the following neuropsychological tests were performed using the Beck Depression Inventory, Parts A and B of the Trail Making Test, eight trials from the Rey Auditory Verbal Learning Test (RAVLT), and the Stroop test.
  
  
  RESULTS
  Patients who maintained paroxysmal AF for the whole study observation period (n = 10) had a significantly greater score in the sixth (A6) and seventh (A7) RAVLT trials (pertaining to parameters of long-term latent memory) at the start of the study. An association between lower RAVLT A6 and A7 trial scores and the risk of paroxysmal arrhythmia progression to permanent AF was confirmed using the Cox proportional hazards regression model and Kaplan-Meier survival analysis.
  
  
  CONCLUSIONS
  A better long-term latent memory RAVLT score was associated with a favourable prognosis of sinus rhythm maintenance. Cognitive impairment should be investigated in patients with AF for the purpose of evaluating the patient's prognosis, subclinical injury to the cardiovascular system, and the ability to comply with treatment.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Mietła
authors.forename: Jacek
authors.initials: J
authors.lastname: Budzyński
authors.forename: Maciej
authors.initials: M
authors.lastname: Bieliński
authors.affiliation: Clinic of Vascular and Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, Poland; Chair of Clinical Neuropsychology, Faculty of Health Sciences, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland. artur.mieczkowski@gmail.com.
authors.forename: Artur
authors.initials: A
authors.lastname: Mieczkowski
authors.forename: Joanna
authors.initials: J
authors.lastname: Pulkowska-Ulfig
authors.forename: Alina
authors.initials: A
authors.lastname: Borkowska
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011379:Prognosis; D016016:Proportional Hazards Models
keywords: atrial fibrillation; cognitive impairment; latent memory; risk factors