Comparison of Brain Perfusion in Rhythm Control and Rate Control of Persistent Atrial Fibrillation

Comparison of Brain Perfusion in Rhythm Control and Rate Control of Persistent Atrial Fibrillation: Prospective Randomized Trial

Atrial fibrillation (AF) is associated with impaired cognitive function (CogF) and/or dementia, but it is unclear whether rhythm control of AF improves CogF or brain perfusion. The hypothesis is rhythm control of AF improves CogF by increasing brain perfusion with hemodynamic amelioration compared to AF state. We will randomize the patients with persistent AF to rhythm control group and rate control group, and check baseline and 3rd month cognitive function (K-MOCA score) and brain perfusion CT. K-MOCA score and brain perfusion CT findings will be compared between rhythm control group and rate control group of persistent AF.

Inclusion Criteria:

• Patients with persistent Atrial fibrillation (20~80 years old)
• LA diameter < 55mm
• patients possible to anticoagulation and anti arrhythmic drug

Exclusion Criteria:

• Structural cardiac disease
• Contraindication to brain perfusion CT
• Catheter ablation history for AF, Cardiac surgery
• active internal bleeding
• Impossible to anticoagulation or antiarrhythmic drug
• valvular AF ((MA> GII, Mechanical valve, Mitral valve replacement)
• LVEF < 30%
• With severe medical disease
• Expected survival < 1 year
• Severe alcoholics, drug addiction