BACKGROUND: We tested the hypothesis that patients with untreated obstructive sleep apnea (OSA) would be at increased risk for recurrence of atrial fibrillation (AF) after cardioversion. METHODS AND RESULTS: We prospectively obtained data on history, echocardiogram, ECG, body mass index, hypertension, diabetes, NYHA functional class, ejection fraction, left atrial appendage velocity, and medications in patients with AF/atrial flutter referred for DC cardioversion. Forty-three individuals were identified as having OSA on the basis of a previous sleep study. Data regarding the use of continuous positive airway pressure (CPAP) and recurrence of AF were obtained for 39 of these patients. Follow-up data were also obtained in 79 randomly selected postcardioversion patients (controls) who did not have any previous sleep study. Twenty-seven of the 39 OSA patients either were not receiving any CPAP therapy (n=25) or were using CPAP inappropriately (n=2). Recurrence of AF at 12 months in these 27 patients was 82%, higher than the 42% recurrence in the treated OSA group (n=12, P=0.013) and the 53% recurrence (n=79, P=0.009) in the 79 control patients. Of the 25 OSA patients who had not been treated at all, the nocturnal fall in oxygen saturation was greater (P=0.034) in those who had recurrence of AF (n=20) than in those without recurrence (n=5). CONCLUSIONS: Patients with untreated OSA have a higher recurrence of AF after cardioversion than patients without a polysomnographic diagnosis of sleep apnea. Appropriate treatment with CPAP in OSA patients is associated with lower recurrence of AF.
BACKGROUND: We tested the hypothesis that patients with untreated obstructive sleep apnea (OSA) would be at increased risk for recurrence of atrial fibrillation (AF) after cardioversion. METHODS AND RESULTS: We prospectively obtained data on history, echocardiogram, ECG, body mass index, hypertension, diabetes, NYHA functional class, ejection fraction, left atrial appendage velocity, and medications in patients with AF/atrial flutter referred for DC cardioversion. Forty-three individuals were identified as having OSA on the basis of a previous sleep study. Data regarding the use of continuous positive airway pressure (CPAP) and recurrence of AF were obtained for 39 of these patients. Follow-up data were also obtained in 79 randomly selected postcardioversion patients (controls) who did not have any previous sleep study. Twenty-seven of the 39 OSA patients either were not receiving any CPAP therapy (n=25) or were using CPAP inappropriately (n=2). Recurrence of AF at 12 months in these 27 patients was 82%, higher than the 42% recurrence in the treated OSA group (n=12, P=0.013) and the 53% recurrence (n=79, P=0.009) in the 79 control patients. Of the 25 OSA patients who had not been treated at all, the nocturnal fall in oxygen saturation was greater (P=0.034) in those who had recurrence of AF (n=20) than in those without recurrence (n=5). CONCLUSIONS:Patients with untreated OSA have a higher recurrence of AF after cardioversion than patients without a polysomnographic diagnosis of sleep apnea. Appropriate treatment with CPAP in OSA patients is associated with lower recurrence of AF.
Authors: Dominik Linz; Arne van Hunnik; Christian Ukena; Sebastian Ewen; Felix Mahfoud; Stephan H Schirmer; Matthias Lenski; Hans-Ruprecht Neuberger; Ulrich Schotten; Michael Böhm Journal: Clin Res Cardiol Date: 2014-03-29 Impact factor: 5.460
Authors: Richard J Schwab; Safwan M Badr; Lawrence J Epstein; Peter C Gay; David Gozal; Malcolm Kohler; Patrick Lévy; Atul Malhotra; Barbara A Phillips; Ilene M Rosen; Kingman P Strohl; Patrick J Strollo; Edward M Weaver; Terri E Weaver Journal: Am J Respir Crit Care Med Date: 2013-09-01 Impact factor: 21.405
Authors: Jacek Wolf; Jacek Drozdowski; Krzysztof Czechowicz; Paweł J Winklewski; Ewa Jassem; Tomas Kara; Virend K Somers; Krzysztof Narkiewicz Journal: Int J Cardiol Date: 2015-08-21 Impact factor: 4.164