NEUROPSYCHOLOGICAL DEFICITS IN ASYMPTOMATIC ATRIAL-FIBRILLATION

Objective - To assess the preclinical effects on cognitive functions o f nonrheumatic atrial fibrillation (NRAF) in patients with negative hi story for cerebrovascular disease. Materials and methods - The study i ncluded 37 consecutive patients with chronic (n=16, mean age 65.3+/-6. 6 years) or paroxysmal (n=21, mean age 58.3+/-9.5 years) NRAF and an e qual number of control subjects in sinus rhythm, who were matched for age, education and presence of hypertension, A comprehensive neuropsyc hological battery including tests of attention, memory, language and v isuospatial skills was administered. Results - Patients with chronic N RAF showed significantly poorer performances in tasks exploring attent ion and verbal memory functions, while the paroxysmal group was signif icantly impaired in a long-term memory task, The neuropsychological fi ndings were confirmed excluding from both groups patients viith CT evi dence of cerebrovascular damage. A small subgroup of patients was also submitted to cerebral MRI. Conclusion - Neurologically asymptomatic N RAF is related to a subclinical but significant impairment in attentio n and memory. These deficits could be produced by minor ischemic lesio ns due to microembolization, or by diffuse hypoxic damage due to hypop erfusion.