Bonnesen MP, Diederichsen SZ, Isaksen JL, et al. - Over a three-year period, subclinical atrial fibrillation (AF) detected by continuous monitoring and treated with oral anticoagulation (OAC) was not associated with a significant change in Montreal Cognitive Assessment (MoCA) score in a high-risk population.

• In total, 1,194 participants (55.2 % men, mean age 74.5 (± 3.9)) had a combined duration of heart rhythm monitoring of ≈1.3 million days.

• Three hundred thirty-nine of them had adjudicated AF, with a median AF burden of 0.072%, and 324 started OAC.

• Only the AF _low group had a decrease in Montreal Cognitive Assessment (MoCA) score over time after stratifying the participants into AF burden groups (No AF, AF _low (AF burden > 0.25%), and AF _high (AF burden > 0.25%), though this was not significant after adjustment for stroke risk factors.

• A three-year subgroup analysis of 175 participants (14.6%) with a MoCA < 26 found no link to AF diagnosis or burden.