Study Finds Catheter Ablation Significantly Lowers Risk of Dementia in Patients with Atrial Fibrillation

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Investigators Compared AFib Patients Treated with Catheter Ablation to Those Treated with Anti-arrhythmic Drugs Only

IRVINE, Calif. – NOVEMBER 10, 2022 – Biosense Webster, Inc., the global leader in cardiac arrhythmia treatment and part of Johnson & Johnson MedTechi, announced today that data from a Biosense Webster-sponsored study that compares the risk of dementia in patients with atrial fibrillation (AFib) who were treated with catheter ablation (CA) versus anti-arrhythmic drugs (AAD) was published in the American Heart Journal. The study evaluated non-specific catheter claims information and found that CA was associated with significantly lower risk of dementia compared to treatment with AAD only1.

AFib is the most common type of cardiac arrhythmia and impacts nearly 40 million people worldwide2, and 6 million people in the U.S. alone3. Cases of AFib are expected to increase to 16 million by 20504 in the U.S. AFib is associated with significant cardiovascular comorbidity, including multiple forms of brain injury such as stroke, cognitive impairment and dementia5,6. Dementia, in particular, presents a profound burden with more than 10.5 million Americans predicted to be affected by 20507. Historically, dementia in patients with AFib was attributed to multiple strokes; however, studies have shown that AFib is associated with multiple forms of dementia, even in the absence of stroke8.

“Atrial fibrillation and dementia independently are a growing concern with the aging of our population. Through this study we sought to better understand the complex relationship between AFib and dementia by exploring how treatment type for AFib plays a role in the development of dementia, and how clinicians might reduce this risk,” said Emily P. Zeitler, MD, MHS, assistant professor of medicine, Geisel School of Medicine, Dartmouth. “Catheter ablation, as a course of AFib treatment, may reduce this risk.”ii

AFib suppression, or “rhythm control,” often becomes the treatment goal following an AFib diagnosis. This is often attempted first with AAD. For those eligible, catheter ablation is associated with greater reduction in AFib burden, improved quality of life, and reduced mortality and cardiovascular hospitalizations9,10,11.
 
According to the study, AFib patients treated with catheter ablation had a 41% lower risk of dementia compared with those treated with anti-arrhythmic drugs (1.9% vs 3.3%; hazard ratio [HR] 0.59, 95% confidence interval [CI] 0.52-0.67)12. Reduced risk of dementia was observed among both male and female subgroups. The reduction in the risk for dementia associated with catheter ablation versus AAD for the subgroup of female patients was 40%; in males it was 45%13.

“Research like this supports the hypothesis that AFib suppression may reduce the risk of developing dementia,” said Jamie March, head of health economics and market access, Cardiovascular Specialty Solutions Group, Biosense Webster, Inc. “That understanding underscores the importance of innovations like catheter ablation to the large and growing AFib patient population.” 

To learn more about atrial fibrillation, visit www.getsmartaboutafib.com. To review the manuscript in full, please visit www.sciencedirect.com

Media Contacts: 
Diane Pressman
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Charlene DeBar
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Study Methodology
Using the 2000-2021 Optum Clinformatics database, patients with AFib who underwent catheter ablation versus anti-arrhythmic drugs treatment (≥1 prescription fill for ≥2 different AADs) were identified and propensity score matched overall and within sex subgroups. After matching, there were 19.088 patients per group. A cause-specific hazard model was performed to assess dementia overall and in sex-specific subgroups. 

About Biosense Webster 
Biosense Webster is the global market leader in the science and technology behind the diagnosis and treatment of cardiac arrhythmias. Part of the Johnson & Johnson MedTech Family of Companies, the specialized medical-technology company is headquartered in Irvine, Calif., and works across the world to advance the tools and solutions that help electrophysiologists identify, treat, and deliver care. Learn more at www.biosensewebster.com and connect on LinkedIn and Twitter.

About Johnson & Johnson MedTech 
At Johnson & Johnson MedTech, we unleash diverse healthcare expertise, purposeful technology, and a passion for people to transform the future of medical intervention and empower everyone to live their best life possible. For more than a century, we have driven breakthrough scientific innovation to address unmet needs and reimagine health. In surgery, orthopaedics, vision, and interventional solutions, we continue to help save lives and create a future where healthcare solutions are smarter, less invasive, and more personalized. For more information, visit www.jnjmedtech.com

Cautions Concerning Forward-Looking Statements
This press release contains “forward-looking statements” as defined in the Private Securities Litigation Reform Act of 1995 regarding data from a Biosense Webster-sponsored study that compares the risk of dementia in patients with atrial fibrillation (AFib) who were treated with catheter ablation (CA) versus anti-arrhythmic drugs (AAD) that was published in the American Heart Journal. The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of Biosense Webster, Inc., any of the other Johnson & Johnson MedTech Companies and/or Johnson & Johnson. Risks and uncertainties include, but are not limited to: uncertainty of regulatory approvals; uncertainty of commercial success; challenges to patents; competition, including technological advances, new products and patents attained by competitors; product efficacy or safety concerns resulting in product recalls or regulatory action; changes to applicable laws and regulations, including global health care reforms; changes in behavior and spending patterns of purchasers of health care products and services; and trends toward health care cost containment. A further list and descriptions of these risks, uncertainties and other factors can be found in Johnson & Johnson’s Annual Report on Form 10-K for the fiscal year ended January 2, 2022, including in the sections captioned “Cautionary Note Regarding Forward-Looking Statements” and “Item 1A. Risk Factors,” and in Johnson & Johnson’s subsequent Quarterly Reports on Form 10-Q and other filings with the Securities and Exchange Commission. Copies of these filings are available online at www.sec.gov, www.jnj.com or on request from Johnson & Johnson. Neither Biosense Webster, Inc., the Johnson & Johnson MedTech Companies nor Johnson & Johnson undertakes to update any forward-looking statement as a result of new information or future events or developments.

  1. Johnson & Johnson MedTech comprises the surgery, orthopedics, vision and interventional solutions businesses within Johnson & Johnson’s MedTech segment.
  2. Biosense Webster, Inc. entered into an Authorship agreement with Dr. Zeitler. She has not been compensated.
  1. Zeitler, Emily P., Bunch, Jared T., et al. Comparative risk of dementia among patients with atrial fibrillation treated with catheter ablation versus anti-arrhythmic drugs. American Heart Journal. September 2022.
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  3. Mody BP, Raza A, Jacobson J, Iwai S, Frenkel D, Rojas R, Aronow WS. Ablation of long-standing persistent atrial fibrillation. Ann Transl Med. 2017 Aug;5(15):305. doi: 10.21037/atm.2017.05.21. PMID: 28856145; PMCID: PMC5555980.
  4. Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, Seward JB, Tsang TS. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006; 114:119–125. doi: 10.1161/CIRCULATIONAHA.105.595140.
  5. Koh YH, Lew LZW, Franke KB, Elliott AD, Lau DH, Thiyagarajah A, Linz D, Arstall M, Tully PJ, Baune BT, Munawar DA and Mahajan R. Predictive role of atrial fibrillation in cognitive decline: a systematic review and meta-analysis of 2.8 million individuals. EP Europace. 2022.
  6. Diener HC, Hart RG, Koudstaal PJ, Lane DA and Lip GYH. Atrial Fibrillation and Cognitive Function: JACC Review Topic of the Week. Journal of the American College of Cardiology. 2019;73:612-619.
  7. G. B. D. Dementia Forecasting Collaborators. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2022;7:e105-e125.
  8. Saglietto A, Matta M, Gaita F, Jacobs V, Bunch TJ and Anselmino M. Stroke-independent contribution of atrial fibrillation to dementia: a meta-analysis. Open Heart. 2019;6:e000984.
  9. Asad ZUA, Yousif A, Khan MS, Al-Khatib SM and Stavrakis S. Catheter Ablation Versus Medical Therapy for Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Circ Arrhythm Electrophysiol. 2019;12:e007414.
  10. Mark DB, Anstrom KJ, Sheng S, Piccini JP, Baloch KN, Monahan KH, Daniels MR, Bahnson TD, Poole JE, Rosenberg Y, Lee KL, Packer DL and Investigators C. Effect of Catheter Ablation vs Medical Therapy on Quality of Life Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. JAMA. 2019;321:1275-1285.
  11. Marrouche NF, Kheirkhahan M and Brachmann J. Catheter Ablation for Atrial Fibrillation with Heart Failure. The New England journal of medicine. 2018;379:492.
  12. Zeitler, Emily P., Bunch, Jared T., et al.Comparative risk of dementia among patients with atrial fibrillation treated with catheter ablation versus anti-arrhythmic drugs. American Heart Journal. September 2022.
  13. Zeitler, Emily P., Bunch, Jared T., et al.Comparative risk of dementia among patients with atrial fibrillation treated with catheter ablation versus anti-arrhythmic drugs. American Heart Journal. September 2022.

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