EfFect of Ablation of Persistent AtriaL Fibrillation on COgNitive Function in Individuals With Mild Cognitive Impairment

Inclusion criteria

• Patients aged 60 to 80 years
• Persistent atrial fibrillation
• Patients with an indication for cardiac rhythm control.
• Montreal Cognitive Assessment score between 18 and 25 points corresponding to mild cognitive impairment
• Free subject, not under temporary or permanent guardianship and not subject to subordination
• Subject understanding and accepting the constraints of the study
• Patient covered by French national health insurance or benefiting from it through a third party
• Subject has given written consent to the study after having received clear and complete information

Exclusion criteria

• Impossibility to perform the neuropsychological evaluation (communication problems such as hearing loss or aphasia, language barrier)
• History of clinical stroke
• Presence of a bruit at carotid auscultation or history of severe carotid stenosis
• History or suspicion of neurodegenerative disease (Parkinson's disease, Alzheimer's disease, Huntington's disease and amyotrophic lateral sclerosis...), bipolar disorder, schizophrenia, severe depression or amyloidosis
• Patient with history of previous atrial fibrillation ablation
• Patient undergoing flutter ablation or atrial tachycardia ablation (not atrial fibrillation ablation)
• Contraindication to atrial fibrillation ablation (intracardiac thrombus, severe pulmonary hypertension, mechanical mitral valve prosthesis or contraindication to anticoagulation,…)
• Contraindication to antiarrhythmic drugs, or to implantable cardiac monitor
• Patient with very advanced persistent atrial fibrillation, i.e., for more than 3 years or with a left atrial diameter \>60 mm in parasternal long axis section or a left atrial volume \> 48ml/m2 in echocardiography
• Subject with a life expectancy of less than 24 months at study enrolment
• Inability to consent
• Persons benefiting from a reinforced protection, namely minors, persons deprived of liberty by a judicial or administrative decision, adults under legal protection, and finally patients in emergency situations
• Pregnant or breastfeeding women, women at age to procreate and not using effective contraception (hormonal/barrier: oral, parenteral, percutaneous implantable, intrauterine device, or surgical: tubal ligation, hysterectomy, total ovariectomy)