Effects of atrial fibrillation catheter ablation vs medical therapy on cognitive function and psychological distress: a randomized clinical trial
Bibliographic record
Abstract
Abstract Background Atrial fibrillation (AF) has been recently linked to cognitive dysfunction and mental health problems. However, the impact of catheter ablation on cognitive performance and psychological distress remains unclear. Objective To determine whether AF catheter ablation is associated with greater improvements in cognitive function and psychological distress compared with medical therapy alone. Methods The Emotion and Cognitive Function after Atrial Fibrillation Catheter Ablation vs. Medical Therapy (EMOTICON) study randomized AF patients 1:1 to either catheter ablation or medical therapy. The primary outcome was a significant improvement in the Montreal Cognitive Assessment (MoCA) score from baseline and to 6 months. Secondary outcomes included the prevalence of severe depression (Center for Epidemiologic Studies-Depression [CES-D] score ³21) and moderate or severe anxiety (Generalized Anxiety Disorder-7 [GAD-7] anxiety scale ³10). Results A total of 295 participants completed the study protocol. Median age was 60 years (26.8% women, 53.2% with persistent AF). At 6 months, cognitive improvement was observed in 6.4% (9 of 140) of the ablation group and 7.1% (11 of 155) of the medical therapy group (P=0.833). There were no cases of cognitive deterioration in either groups. The prevalence of severe depression at 6 months was 6.4% (9 of 140) in the ablation group and 10.3% (16 of 155) in the medical therapy group (P=0.322). Similarly, moderate to severe anxiety was reported in 3.6% (5 of 140) of the ablation group and 5.2% (n=8 of 155) of the medical therapy group. Conclusions AF catheter ablation did not result in greater cognitive improvement compared to medical therapy. However, psychological distress measures, including depression and anxiety, were numerically lower in the ablation group, though not statistically significant.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".