Increased Cerebral Blood Flow after Catheter Ablation in Atrial Fibrillation: A Multi-delay ASL-based Study

Motivation: Cerebral hypoperfusion may be a major link between atrial fibrillation (AF) and neuropathologic processes. Whether catheter ablation can effectively improve cerebral perfusion needs to be evaluated by noninvasive methods. Goal(s): To assess the effects of catheter ablation on overall and regional cerebral blood perfusion in AF patients using multi-delay ASL. Approach: Multi-delay ASL was performed before and after catheter ablation to calculate arterial transit time and cerebral blood flow. Whole and regional cerebral perfusion parameters before and after ablation were characterized and compared in paroxysmal and non-paroxysmal groups. Results: Cather ablation significantly increased overall and regional cerebral blood perfusion, especially in non-paroxysmal AF. Impact: Catheter ablation can improve cerebral perfusion and maintain brain health, which should be considered even in asymptomatic patients. Multi-delay ASL can be used to evaluate and monitor cerebral perfusion in AF and help with patient screening and therapeutic strategy development.