Gunn Marit Traaen1,2,3, Lars Aakerøy4,5, Tove-Elizabeth Hunt1,6,2, Britt Øverland7, Christina Bendz1, Lars Øivind Sande8, Svend Aakhus9,10, Morten Wang Fagerland11, Sigurd Steinshamn4,5, Ole-Gunnar Anfinsen1,6, Richard John Massey1,2, Kaspar Broch1,3, Thor Ueland12, Harriet Akre13,2, Jan Pål Loennechen9,5, Lars Gullestad1,2,3. 1. Department of Cardiology, Rikshospitalet. 2. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. 3. KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway and Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway. 4. Department of Thoracic Medicine, and. 5. Department of Circulation and Medical Imaging, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway. 6. Department of Cardiology and Center for Cardiological Innovation, Rikshospitalet. 7. Department of Otorhinolaryngology, Head & Neck Surgery, Sleep Unit, Lovisenberg Diakonale Hospital, Oslo, Norway. 8. Moloklinikken, Fornebu, Norway; and. 9. Department of Cardiology, St. Olavs University Hospital, Trondheim, Norway. 10. Department of Circulation and Imaging, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway. 11. Oslo Centre for Biostatistics and Epidemiology, Research Support Services. 12. Research Institute of Internal Medicine, Rikshospitalet. 13. Department of Otorhinolaryngology, Head & Neck Surgery, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
Abstract
Rationale: Sleep apnea (SA) is highly prevalent in patients with atrial fibrillation (AF), and both conditions are associated with adverse cardiovascular outcomes. Objectives: To determine the effect of continuous positive airway pressure (CPAP) on AF burden. Methods: This open-label, parallel-group, randomized controlled trial included patients with paroxysmal AF and moderate to severe SA (apnea-hypopnea index ⩾15). A computerized system randomized eligible patients (1:1) to 5 months' treatment with CPAP plus usual care (CPAP, n = 55) or usual care alone (control, n = 54). The outcome assessment was blinded. The planned primary outcome was the difference between CPAP treatment and control groups in change of AF burden (percentage of time in AF) as measured by implantable loop recorder.Measurements and Main Results: A total of 579 patients with paroxysmal AF had respiratory polygraphy, of whom 244 (42%) had moderate to severe SA. Of these, 158 (65%) participated in the CPAP run-in period, of whom 39 (25%) patients did not tolerate the treatment. A total of 108 patients were available for the primary analysis. The mean time in AF decreased from 5.6% at baseline to 4.1% during the last 3 months of CPAP intervention and from 5.0% to 4.3% in the control group. The adjusted between-group difference at follow-up was -0.63 (95% confidence interval, -2.55 to 1.30) percentage points (P = 0.52). Seven serious adverse events (13%) occurred in the CPAP group, and two (4%) occurred in the control group.Conclusions: In patients with paroxysmal AF and SA, treatment with CPAP did not result in a statistically significant reduction in the burden of AF.Clinical trial registered with www.clinicaltrials.gov (NCT02727192).
Rationale: Sleep apnea (SA) is highly prevalent in patients with atrial fibrillation (AF), and both conditions are associated with adverse cardiovascular outcomes. Objectives: To determine the effect of continuous positive airway pressure (CPAP) on AF burden. Methods: This open-label, parallel-group, randomized controlled trial included patients with paroxysmal AF and moderate to severe SA (apnea-hypopnea index ⩾15). A computerized system randomized eligible patients (1:1) to 5 months' treatment with CPAP plus usual care (CPAP, n = 55) or usual care alone (control, n = 54). The outcome assessment was blinded. The planned primary outcome was the difference between CPAP treatment and control groups in change of AF burden (percentage of time in AF) as measured by implantable loop recorder.Measurements and Main Results: A total of 579 patients with paroxysmal AF had respiratory polygraphy, of whom 244 (42%) had moderate to severe SA. Of these, 158 (65%) participated in the CPAP run-in period, of whom 39 (25%) patients did not tolerate the treatment. A total of 108 patients were available for the primary analysis. The mean time in AF decreased from 5.6% at baseline to 4.1% during the last 3 months of CPAP intervention and from 5.0% to 4.3% in the control group. The adjusted between-group difference at follow-up was -0.63 (95% confidence interval, -2.55 to 1.30) percentage points (P = 0.52). Seven serious adverse events (13%) occurred in the CPAP group, and two (4%) occurred in the control group.Conclusions: In patients with paroxysmal AF and SA, treatment with CPAP did not result in a statistically significant reduction in the burden of AF.Clinical trial registered with www.clinicaltrials.gov (NCT02727192).
Authors: Michael Dong; Linda Liu; Kenneth C Bilchick; Nishaki K Mehta; Yoon-Sik Cho; Ryan J Koene; Selcuk Adabag; Adrian Baranchuk; Neal A Chatterjee; T Jared Bunch; Hirad Yarmohammadi; Younghoon Kwon Journal: Sleep Breath Date: 2022-06-01 Impact factor: 2.816
Authors: John de Heide; Danielle B M Kock-Cordeiro; Rohit E Bhagwandien; Mark G Hoogendijk; Koen C van der Meer; Sip A Wijchers; Tamas Szili-Torok; Felix Zijlstra; Mattie J Lenzen; Sing-Chien Yap Journal: Int J Cardiol Heart Vasc Date: 2022-03-24
Authors: Michael Arzt; Marzena A Drzymalski; Sarah Ripfel; Sebastian Meindl; Alexander Biedermann; Melanie Durczok; Karoline Keller; Julian Mustroph; Sylvia Katz; Maria Tafelmeier; Simon Lebek; Bernhard Flörchinger; Daniele Camboni; Sigrid Wittmann; Johannes Backs; Christof Schmid; Lars S Maier; Stefan Wagner Journal: Antioxidants (Basel) Date: 2022-02-08
Authors: Jan Pec; Michael Wester; Christoph Fisser; Kurt Debl; Okka W Hamer; Florian Poschenrieder; Stefan Buchner; Lars S Maier; Michael Arzt; Stefan Wagner Journal: J Clin Med Date: 2021-11-26 Impact factor: 4.241
Authors: Michael D Faulx; Reena Mehra; Glaucylara Reis Geovanini; Shin-Ichi Ando; Michael Arzt; Luciano Drager; Michael Fu; Camilla Hoyos; Jo Hai; Juey-Jen Hwang; Remzi Karaoguz; John Kimoff; Pei-Lin Lee; Olga Mediano; Sanjay R Patel; Yüksel Peker; Jean Louis Pepin; Manuel Sanchez-de-la-Torre; Frédéric Sériès; Stefan Stadler; Patrick Strollo; A A Tahrani; Erik Thunström; Motoo Yamauchi; Susan Redline; Craig L Phillips Journal: Int J Cardiol Heart Vasc Date: 2022-07-19
Authors: Maddalena Ardissino; Rohin K Reddy; Eric A W Slob; Kiran H K Patel; David K Ryan; Dipender Gill; Fu Siong Ng Journal: Genes (Basel) Date: 2022-01-02 Impact factor: 4.141