Obstructive Sleep Apnea Is Closely Related to Cardiovascular Risk Factors, but Not to Clinical Recurrence of Atrial Fibrillation After Catheter Ablation: An Analysis of Atrial Fibrillation Patients

Overview

Journal Pulse (Basel)

Specialty Cardiology & Vascular Diseases

Date 2018 Oct 5

PMID 30283752

Citations 1

Authors

Chan Joo Lee

Tae-Hoon Kim

Sungha Park

Hui-Nam Pak

Affiliations

Soon will be listed here.

Abstract

Background: Obstructive sleep apnea (OSA) is a well-known predictor of atrial fibrillation (AF). However, OSA usually accompanies other risk factors of AF. We tried to investigate whether OSA is related to AF recurrence after catheter ablation.

Methods: A total of 378 patients (mean age 59.9 ± 10.7 years, 72.5$ male) who underwent catheter ablation of AF were enrolled and underwent overnight ambulatory polysomnography before the ablation procedure. These patients were examined once every 3 months at the outpatient clinic to determine AF recurrence.

Results: Based on the apnea-hypopnea index (AHI), we divided the study subjects into 3 groups defined as mild (AHI < 10), moderate (10 <AHI < 30), or severe (AHI > 30) OSA. Patients with severe OSA had a higher prevalence of hypertension, diabetes mellitus, and coronary artery disease (CAD). However, AF recurrence was not different between the three groups. The Kaplan-Meier analysis also showed no significant difference in AF recurrence according to the degree of severity of OSA. Multivariate logistic regression analysis revealed that OSA might be a predictor of CAD; however, Cox regression analysis showed that only early recurrence is closely related to AF recurrence after catheter ablation, rather than the severity of OSA.

Conclusion: This study shows that the severity of OSA is not associated with the recurrence of AF after catheter ablation in Korean patients. Treatment of OSA for the sole indication of lowering AF recurrence may need to be reconsidered.

Citing Articles

Sleep Apnea and Heart.

Kwon Y, Logan J, Pusalavidyasagar S, Kasai T, Cheong C, Lee C Sleep Med Res. 2020; 10(2):67-74.

PMID: 32699652 PMC: 7375706. DOI: 10.17241/smr.2019.00493.

References

Tang R, Dong J, Liu X, Kang J, Ding S, Wang L . Obstructive sleep apnoea risk profile and the risk of recurrence of atrial fibrillation after catheter ablation. Europace. 2008; 11(1):100-5. DOI: 10.1093/europace/eun315. View

Kanagala R, Murali N, Friedman P, Ammash N, Gersh B, Ballman K . Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation. 2003; 107(20):2589-94. DOI: 10.1161/01.CIR.0000068337.25994.21. View

Matiello M, Nadal M, Tamborero D, Berruezo A, Montserrat J, Embid C . Low efficacy of atrial fibrillation ablation in severe obstructive sleep apnoea patients. Europace. 2010; 12(8):1084-9. DOI: 10.1093/europace/euq128. View

Naruse Y, Tada H, Satoh M, Yanagihara M, Tsuneoka H, Hirata Y . Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation: clinical impact of continuous positive airway pressure therapy. Heart Rhythm. 2012; 10(3):331-7. DOI: 10.1016/j.hrthm.2012.11.015. View

Sankri-Tarbichi A . Obstructive sleep apnea-hypopnea syndrome: Etiology and diagnosis. Avicenna J Med. 2012; 2(1):3-8. PMC: 3507069. DOI: 10.4103/2231-0770.94803. View

Shamsuzzaman A, Gersh B, Somers V . Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA. 2003; 290(14):1906-14. DOI: 10.1001/jama.290.14.1906. View

Worsnop C, Naughton M, Barter C, Morgan T, Anderson A, Pierce R . The prevalence of obstructive sleep apnea in hypertensives. Am J Respir Crit Care Med. 1998; 157(1):111-5. DOI: 10.1164/ajrccm.157.1.9609063. View

Abecasis J, Dourado R, Ferreira A, Saraiva C, Cavaco D, Reis Santos K . Left atrial volume calculated by multi-detector computed tomography may predict successful pulmonary vein isolation in catheter ablation of atrial fibrillation. Europace. 2009; 11(10):1289-94. DOI: 10.1093/europace/eup198. View

Duran-Cantolla J, Aizpuru F, Martinez-Null C, Barbe-Illa F . Obstructive sleep apnea/hypopnea and systemic hypertension. Sleep Med Rev. 2009; 13(5):323-31. DOI: 10.1016/j.smrv.2008.11.001. View

10.

Iber C, Redline S, Kaplan Gilpin A, Quan S, Zhang L, Gottlieb D . Polysomnography performed in the unattended home versus the attended laboratory setting--Sleep Heart Health Study methodology. Sleep. 2004; 27(3):536-40. DOI: 10.1093/sleep/27.3.536. View

11.

Marin J, Carrizo S, Vicente E, Agusti A . Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005; 365(9464):1046-53. DOI: 10.1016/S0140-6736(05)71141-7. View

12.

Mehra R, Stone K, Varosy P, Hoffman A, Marcus G, Blackwell T . Nocturnal Arrhythmias across a spectrum of obstructive and central sleep-disordered breathing in older men: outcomes of sleep disorders in older men (MrOS sleep) study. Arch Intern Med. 2009; 169(12):1147-55. PMC: 2802061. DOI: 10.1001/archinternmed.2009.138. View

13.

Shim J, Joung B, Park J, Uhm J, Lee M, Pak H . Long duration of radiofrequency energy delivery is an independent predictor of clinical recurrence after catheter ablation of atrial fibrillation: over 500 cases experience. Int J Cardiol. 2012; 167(6):2667-72. DOI: 10.1016/j.ijcard.2012.06.120. View

14.

Fein A, Shvilkin A, Shah D, Haffajee C, Das S, Kumar K . Treatment of obstructive sleep apnea reduces the risk of atrial fibrillation recurrence after catheter ablation. J Am Coll Cardiol. 2013; 62(4):300-5. DOI: 10.1016/j.jacc.2013.03.052. View

15.

Epstein L, Kristo D, Strollo Jr P, Friedman N, Malhotra A, Patil S . Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009; 5(3):263-76. PMC: 2699173. View

16.

Peppard P, Young T, Palta M, Skatrud J . Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000; 342(19):1378-84. DOI: 10.1056/NEJM200005113421901. View

17.

Kim Y, Suh Y, Choi H . BMI and metabolic disorders in South Korean adults: 1998 Korea National Health and Nutrition Survey. Obes Res. 2004; 12(3):445-53. DOI: 10.1038/oby.2004.50. View

18.

Bruyneel M, Sanida C, Art G, Libert W, Cuvelier L, Paesmans M . Sleep efficiency during sleep studies: results of a prospective study comparing home-based and in-hospital polysomnography. J Sleep Res. 2010; 20(1 Pt 2):201-6. DOI: 10.1111/j.1365-2869.2010.00859.x. View

19.

Parati G, Lombardi C, Hedner J, Bonsignore M, Grote L, Tkacova R . Recommendations for the management of patients with obstructive sleep apnoea and hypertension. Eur Respir J. 2013; 41(3):523-38. DOI: 10.1183/09031936.00226711. View

20.

Calkins H, Kuck K, Cappato R, Brugada J, Camm A, Chen S . 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace. 2012; 14(4):528-606. DOI: 10.1093/europace/eus027. View