Yunxiao Yang1, Yu Ning1, Wanwan Wen1, Yifan Jia1, Xiaoyuan Chen2, Mengling Huang1, Jaskanwal Deep Sara3, Yanwen Qin4, Fang Fang4, Huina Zhang4, Yunhui Du4, Linyi Li4, Xiaolu Jiao4, Yunyun Yang4, Xingyu Han4,5, Ming Zhang6, Yongxiang Wei7. 1. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No.2, Anzhen Road, Chaoyang District, Beijing, 100029, China. 2. Department of Endocrinology, People's Hospital of Gaotang Country, Liaocheng, Shandong, China. 3. Division of Cardiovascular Diseases, Mayo College of Medicine, Rochester, MN, USA. 4. Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 5. Department of Otolaryngology Head & Neck Surgery, Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, No 2, Anzhen Road, Chaoyang District, Beijing, 100029, China. 6. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No.2, Anzhen Road, Chaoyang District, Beijing, 100029, China. zhangming2279@hotmail.com. 7. Department of Otolaryngology Head & Neck Surgery, Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, No 2, Anzhen Road, Chaoyang District, Beijing, 100029, China. weiyongxiang@vip.sina.com.
Abstract
PURPOSE: Obstructive sleep apnea (OSA) is associated with the management of atrial fibrillation (AF). This manuscript aims to discuss the effects of continuous positive airway pressure (CPAP) in patients with rhythm control strategies and patients with different ages, weights and length of follow-up. METHODS: We searched Embase, PubMed, Cochrane, Web of Science and Ovid for relevant studies (from inception to 7 July 2019; English). The primary outcome was documented AF recurrence in CPAP users and nonusers. We assessed pooled data by use of a random-effects model. RESULTS: Nine prospective cohort studies with a total of 2134 participants met the inclusion criteria. Results showed that complementary CPAP therapy reduced AF recurrence (RR = 0.63; 95% CI, 0.56-0.72). In subgroup analyses, the benefits of CPAP were stronger in patients younger than 60 years old (< 60 years old: RR, 0.59; 95% CI, 0.50-0.68 vs. ≥ 60 years old: RR, 0.73; 95% CI, 0.59-0.91), with a body mass index (BMI) of less than 30 (< 30: RR, 0.53; 95% CI, 0.37-0.77 vs. ≥ 30: RR, 0.65; 95% CI, 0.55-0.77) or with less follow-up time (≤ 1 year: RR, 0.57; 95% CI, 0.42-0.79 vs. > 1 year: RR, 0.64; 95% CI, 0.53-0.78). CONCLUSIONS: Complementary CPAP therapy reduces the risk of AF recurrence in OSA patients with rhythm control strategies. In addition to weight control and early AF intervention, CPAP compliance should be recommended along with periodic adjustments as necessary.
PURPOSE: Obstructive sleep apnea (OSA) is associated with the management of atrial fibrillation (AF). This manuscript aims to discuss the effects of continuous positive airway pressure (CPAP) in patients with rhythm control strategies and patients with different ages, weights and length of follow-up. METHODS: We searched Embase, PubMed, Cochrane, Web of Science and Ovid for relevant studies (from inception to 7 July 2019; English). The primary outcome was documented AF recurrence in CPAP users and nonusers. We assessed pooled data by use of a random-effects model. RESULTS: Nine prospective cohort studies with a total of 2134 participants met the inclusion criteria. Results showed that complementary CPAP therapy reduced AF recurrence (RR = 0.63; 95% CI, 0.56-0.72). In subgroup analyses, the benefits of CPAP were stronger in patients younger than 60 years old (< 60 years old: RR, 0.59; 95% CI, 0.50-0.68 vs. ≥ 60 years old: RR, 0.73; 95% CI, 0.59-0.91), with a body mass index (BMI) of less than 30 (< 30: RR, 0.53; 95% CI, 0.37-0.77 vs. ≥ 30: RR, 0.65; 95% CI, 0.55-0.77) or with less follow-up time (≤ 1 year: RR, 0.57; 95% CI, 0.42-0.79 vs. > 1 year: RR, 0.64; 95% CI, 0.53-0.78). CONCLUSIONS: Complementary CPAP therapy reduces the risk of AF recurrence in OSA patients with rhythm control strategies. In addition to weight control and early AF intervention, CPAP compliance should be recommended along with periodic adjustments as necessary.
Authors: Samantha Y Starkey; Daniel R Jonasson; Stephanie Alexis; Susan Su; Ravinder Johal; Paul Sweeney; Penelope M A Brasher; John Fleetham; Najib Ayas; Teddi Orenstein; Iqbal H Ahmed Journal: CJC Open Date: 2020-12-03