BACKGROUND: The relationship between obstructive sleep apnea (OSA) and increased risk for atrial fibrillation (AF) has been well established in previous studies. The relationship between OSA and silent AF is unknown. We hypothesized that patients with OSA but no known history of AF are at an increased risk for the arrhythmia and may be detectable by prolonged electrocardiogram (ECG) monitoring. In this study, we examined whether 7 days of extended cardiac monitoring with an ECG event recorder is an effective screening tool to detect intermittent, silent AF in patients with severe OSA. METHODS: The study was a prospective observational study. Randomly chosen patients with newly diagnosed severe OSA, apnea-hypopnea index (AHI) ≥ 30, were included. Demographic, medical history, and sleep data were collected. Patients with a history of AF or symptoms of palpitations were excluded from participating. Seven consecutive days of ambulatory ECG event recording (with Model ER920W, eCardio, Houston, TX) were performed prior to the initiation of CPAP treatment. RESULTS: A total of 20 subjects, with a BMI of 38.8 ± 12.2, successfully completed the study. The mean age group was 52.6 ± 12.6 years and mean AHI 63.5 ± 29.2. The majority of subjects (70 %) had no abnormal cardiac rhythms detected. AF lasting for 7 s was seen in one subject, and paroxysmal atrial tachycardia lasting for 3.6 s was seen in another. Clinically relevant AF was not detected in any of the subjects. CONCLUSION: In patients with severe OSA without a known history of AF, 7 days of extended cardiac monitoring with an ECG event recorder did not detect clinically meaningful, silent AF.
BACKGROUND: The relationship between obstructive sleep apnea (OSA) and increased risk for atrial fibrillation (AF) has been well established in previous studies. The relationship between OSA and silent AF is unknown. We hypothesized that patients with OSA but no known history of AF are at an increased risk for the arrhythmia and may be detectable by prolonged electrocardiogram (ECG) monitoring. In this study, we examined whether 7 days of extended cardiac monitoring with an ECG event recorder is an effective screening tool to detect intermittent, silent AF in patients with severe OSA. METHODS: The study was a prospective observational study. Randomly chosen patients with newly diagnosed severe OSA, apnea-hypopnea index (AHI) ≥ 30, were included. Demographic, medical history, and sleep data were collected. Patients with a history of AF or symptoms of palpitations were excluded from participating. Seven consecutive days of ambulatory ECG event recording (with Model ER920W, eCardio, Houston, TX) were performed prior to the initiation of CPAP treatment. RESULTS: A total of 20 subjects, with a BMI of 38.8 ± 12.2, successfully completed the study. The mean age group was 52.6 ± 12.6 years and mean AHI 63.5 ± 29.2. The majority of subjects (70 %) had no abnormal cardiac rhythms detected. AF lasting for 7 s was seen in one subject, and paroxysmal atrial tachycardia lasting for 3.6 s was seen in another. Clinically relevant AF was not detected in any of the subjects. CONCLUSION: In patients with severe OSA without a known history of AF, 7 days of extended cardiac monitoring with an ECG event recorder did not detect clinically meaningful, silent AF.
Authors: Apoor S Gami; Dave O Hodge; Regina M Herges; Eric J Olson; Jiri Nykodym; Tomas Kara; Virend K Somers Journal: J Am Coll Cardiol Date: 2007-01-22 Impact factor: 24.094
Authors: David J Gladstone; John Blakely; Paul Dorian; Melanie Spring; Jiming Fang; Frank L Silver; Moira K Kapral Journal: Stroke Date: 2008-04-03 Impact factor: 7.914
Authors: Taya V Glotzer; Anne S Hellkamp; John Zimmerman; Michael O Sweeney; Raymond Yee; Roger Marinchak; James Cook; Alexander Paraschos; John Love; Glauco Radoslovich; Kerry L Lee; Gervasio A Lamas Journal: Circulation Date: 2003-03-24 Impact factor: 29.690
Authors: Chee Yuan Ng; Tong Liu; Michael Shehata; Steven Stevens; Sumeet S Chugh; Xunzhang Wang Journal: Am J Cardiol Date: 2011-04-29 Impact factor: 2.778
Authors: Emmanuel N Simantirakis; Sophia I Schiza; Mary E Marketou; Stavros I Chrysostomakis; Gregory I Chlouverakis; Nick C Klapsinos; Nikolas S Siafakas; Panos E Vardas Journal: Eur Heart J Date: 2004-06 Impact factor: 29.983
Authors: Muhammad Ghias; Benjamin J Scherlag; Zhibing Lu; Guodong Niu; Annerie Moers; Warren M Jackman; Ralph Lazzara; Sunny S Po Journal: J Am Coll Cardiol Date: 2009-11-24 Impact factor: 24.094
Authors: Reena Mehra; Katie L Stone; Paul D Varosy; Andrew R Hoffman; Gregory M Marcus; Terri Blackwell; Osama A Ibrahim; Rawan Salem; Susan Redline Journal: Arch Intern Med Date: 2009-06-22