Efficacy of catheter ablation of atrial fibrillation in patients with obstructive sleep apnoea with and without continuous positive airway pressure treatment: a meta-analysis of observational studies

Li, Li; Wang, Zengwu; Li, Jie; Ge, Xing; Guo, Lan; Wang, Ying; Guo, Weihua; Jiang, Chen‐Xi; Ma, Changsheng

doi:10.1093/europace/euu066

Cited by 170 publications

(112 citation statements)

References 28 publications

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“…Obturacyjny bezdech senny nasila zmiany ciśnienia wewnątrz klatki piersiowej, które same oraz za pośrednictwem aktywacji nerwu błędnego mogą prowadzić do skrócenia potencjału czynnościowego w przedsionkach i wywoływać AF. Redukcja czynników ryzyka oraz wentylacja z ciągłym dodatnim ciśnieniem w drogach oddechowych mogą ograniczać nawroty AF [308][309][310][311][312]. Wydaje się rozsąd-nym rozważanie przesiewowego wykrywania obturacyjnego bezdechu sennego u pacjentów z AF i obciążonych czynnikami ryzyka.…”

Section: Ablacja Przezcewnikowa U Otyłych Pacjentówunclassified

“…Oprócz farmakoterapii antyarytmicznej i ablacji przezcewnikowej (patrz rozdz. 11.3) również leczenie współ-istniejących chorób układu sercowo-naczyniowego może ograniczyć nasilenie objawów AF i ułatwić utrzymanie rytmu zatokowego [203,204,296,312]. Takie postępowanie obejmuje zmniejszenie masy ciała, kontrolę ciśnienia tętniczego, leczenie niewydolności serca, poprawę wydolności układu sercowo-naczyniowego i oddechowego oraz inne środki (patrz rozdz.…”

Section: Długoterminowe Leczenieunclassified

See 1 more Smart Citation

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,399

4,206

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Section: Ablacja Przezcewnikowa U Otyłych Pacjentówunclassified

Section: Długoterminowe Leczenieunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,399

4,206

View full text Add to dashboard Cite

“…Existing data also suggest that central events may more significantly associate with atrial arrhythmogenesis, while obstructive respiratory events may more strongly contribute to ventricular arrhythmogenesis (9). Although rigorously conducted randomized controlled trials are lacking, data from retrospective studies identify the impact of primarily OSA (but not central sleep apnea [CSA]) treatment on reduction of the recurrence of AF after cardioversion or ablation, and they allude to a potential causal relationship (13)(14)(15)(16)(17).…”

mentioning

confidence: 99%

Central Sleep-disordered Breathing Predicts Incident Atrial Fibrillation in Older Men

May

Blackwell

Stone

et al. 2016

Am J Respir Crit Care Med

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Rationale: Although research supports a sleep-disordered breathing and atrial fibrillation association, prospective data examining sleepdisordered breathing predicting incident atrial fibrillation are lacking.Objectives: To investigate sleep-disordered breathing indices as predictors of incident atrial fibrillation.Methods: A cohort (n = 843) of ambulatory older men without prevalent atrial fibrillation was assessed for baseline sleep indices: apnea-hypopnea index, central sleep apnea (central apnea index, >5 vs. ,5), central sleep apnea or Cheyne-Stokes respiration, obstructive apnea-hypopnea index, and percentage of sleep time with less than 90% oxygen saturation. Incident clinically symptomatic adjudicated or self-reported atrial fibrillation outcome was ascertained (mean follow-up, 6.5 6 0.7 yr). We used logistic regression models adjusted for age, race, body mass index, cardiopulmonary disease, alcohol use, pacemaker, cholesterol, cardiac medications, and alternate apnea type for obstructive and central apnea. Age interaction terms and median age-stratified analyses were performed. Conclusions: In older men, central apnea and Cheyne-Stokes respiration predicted increased atrial fibrillation risk, with findings being strongest in older participants in whom overall sleepdisordered breathing also increased atrial fibrillation risk.

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“…More importantly, the initiation of a specific antiarrhythmic therapy could be prevented in this patient [48]. These antiarrhythmic effects of CPAP therapy are also confirmed in several clinical studies (see chapter 2) [8, 9, 49]. However, whether rate or rhythm control strategy should be aspired in OSA-patients despite the prevention of obstructive respiratory events by CPAP is unknown and deserved further clinical trials.…”

Section: Treatment Options Of Atrial Fibrillation In Patients With Osamentioning

confidence: 79%

Obstructive Sleep Apnea and Atrial Arrhythmogenesis

Hohl¹,

Linz²,

Böhm³

et al. 2014

CCR

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Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with relevant morbidity and mortality. Besides hypertension, valvular disease and cardiomyopathy, mainly ischemic and dilated, also other conditions like obesity, alcohol abusus, genetic factors and obstructive sleep apnea (OSA) are discussed to contribute to the progression from paroxysmal to persistent AF. The prevalence of OSA among patients with AF is 40-50%. OSA is characterized by periodic or complete cessation of effective breathing during sleep due to obstruction of the upper airways. Obstructive respiratory events result in acute intrathoracic pressure swings and profound changes in blood gases together leading to atrial stretch and acute sympatho-vagal dysbalance resulting in acute apnea related to electrophysiological and hemodynamic alterations. Additionally, repetitive obstructive events in patients with OSA may lead to sympathetic and neurohumoral activation and subsequent structural and functional changes in the atrium creating an arrhythmogenic substrate for AF in the long run. This review focuses on the acute and chronic effects of negative thoracic pressure swings, changes in blood pressure and sympatho-vagal dysbalance induced by obstructive respiratory events on atrial electrophysiology and atrial structure in patients with obstructive sleep apnea.

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Efficacy of catheter ablation of atrial fibrillation in patients with obstructive sleep apnoea with and without continuous positive airway pressure treatment: a meta-analysis of observational studies

Abstract: Obstructive sleep apnoea was associated with AF recurrence after catheter ablation. The efficacy of catheter ablation for AF was similar between patients without OSA and patients with OSA undergoing CPAP treatment.

Cited by 170 publications

References 28 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Central Sleep-disordered Breathing Predicts Incident Atrial Fibrillation in Older Men

Obstructive Sleep Apnea and Atrial Arrhythmogenesis

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