Association between atrial fibrillation burden and cognitive function in patients with atrial fibrillation

Figure 1. Increasing AF burden is associated with adverse clinical outcomes. The figure conceptually illustrates the progressive association between increasing AF burden and the risk of adverse clinical outcomes. AF burden seems to be an important marker of disease severity and prognostic risk. As AF burden rises, the incidence of outcomes such as stroke or systemic embolism, heart failure, hospitalization, and mortality generally increases. The figure is intended for illustrative purposes and does not represent validated quantitative AF burden thresholds or risk cut-offs. AF, atrial fibrillation.

Figure 2. Integrated assessment of AF burden and atrial disease. AF burden reflects the quantitative expression of arrhythmia (episode frequency, duration, density, and percentage of time in AF), whereas atrial disease represents the underlying structural, electrical, and functional atrial substrate. Combining continuous rhythm monitoring with imaging, electroanatomical mapping, biomarkers, and clinical characteristics provides a comprehensive assessment of disease severity, enabling improved prediction of stroke, HF, AF progression, symptoms, and catheter ablation outcomes, while supporting individualized rhythm-control strategies. AF, atrial fibrillation; LA, left atrial; U/S, ultrasound; CMR, cardiovascular magnetic resonance; LGE, late gadolinium enhancement; CIEDs, cardiac implantable electronic devices; ILR, implantable loop recorder; ECG, electrocardiogram; NT-proBNP, N-terminal pro–B-type natriuretic peptide; MMP-2, matrix metalloproteinase-2; NOTCH3, neurogenic locus notch homolog protein 3; TNFR2, tumor necrosis factor receptor 2; ANGPT2, angiopoietin-2; GDF-15, Growth differentiation factor-15; DM, diabetes mellitus.