Evidence map›Paper›PMID 30275499›Full record

ReviewNature reviews. Cardiology2018

Cognitive dysfunction in atrial fibrillation.

Malini Madhavan, Jonathan Graff-Radford, Jonathan P Piccini, Bernard J Gersh

Abstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed, 3 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

79 citing papers in PubMed, 3 syntheses or guidelines pooled it, 121 citations in OpenAlex.

  1. Beyond the beats: a systematic review of the underlying inflammatory pathways between atrial fibrillation and cognitive decline.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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  10. The Fibrillatory Wave Amplitude of ECG Decreases Over Time in Patients With Persistent AF: A Retrospective Cohort Study.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026
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19 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Malini MadhavanDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. madhavan.malini@mayo.edu.
Jonathan Graff-RadfordDepartment of Neurology, Mayo Clinic, Rochester, MN, USA.
Jonathan P PicciniDivision of Cardiology, Duke University Medical Center and Duke Clinical Research Unit, Durham, NC, USA.
Bernard J GershDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Mayo Clinic in Arizona · USDuke Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Atrial fibrillation (AF) is the most common arrhythmia in adults, and its incidence and prevalence increase with age. The risk of cognitive impairment and dementia also increases with age, and both AF and cognitive impairment or dementia share important risk factors. In meta-analyses of published studies, AF is associated with a 2.4-fold and 1.4-fold increase in the risk of dementia in patients with or without a history of stroke, respectively. This association is independent of shared risk factors such as hypertension and diabetes mellitus. Neuroimaging has illustrated several potential mechanisms of cognitive decline in patients with AF. AF is associated with increased prevalence of silent cerebral infarcts, and more recent data also suggest an increased prevalence of cerebral microbleeds with AF. AF is also associated with a pro-inflammatory state, and the relationship between AF-induced systemic inflammation and dementia remains to be investigated. Preliminary reports indicate that anticoagulation medication including warfarin can reduce the risk of cognitive impairment in patients with AF. Catheter ablation, increasingly used to maintain sinus rhythm in patients with AF, is associated with the formation of new silent cerebral lesions. The majority of these lesions are not detectable after 1 year, and insufficient data are available to evaluate their effect on cognition. Large prospective studies are urgently needed to confirm the association between AF and dementia, to elucidate the associated mechanisms, and to investigate the effect of anticoagulation and rhythm control on cognition.

Indexed as

CognitionAdultAgedAged, 80 and overAge FactorsAnticoagulantsAtrial FibrillationCatheter AblationCerebrovascular DisordersCognition DisordersCognitive AgingFemaleHeart Conduction SystemHumansIncidenceMaleAnticoagulants

Identifiers

PMID30275499
OpenAlexW2895433001

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.