Prevalence and Assessment of Sleep-Disordered Breathing in Patients With Atrial Fibrillation: A Systematic Review and Meta-analysis

Kadhim, Kadhim; Middeldorp, Melissa E.; Elliott, Adrian D.; Agbaedeng, T.; Gallagher, Celine; Malik, Varun; Wong, Christopher X.; McEvoy, R. Doug; Kalman, Jonathan M.; Lau, Dennis H.; Linz, Dominik; Sanders, Prashanthan

doi:10.1016/j.cjca.2021.09.026

Cited by 30 publications

(21 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…OSA has been reported to be present in up to 78% of AF patients 2,19 . Aside from structurally induced changes due to chronic OSA, 20 such as atrial enlargement and increased fibrosis formation, there is a growing body of evidence supporting relevant acute and transient arrhythmogenic changes induced by single apneas or single nights of severe OSA 6,8 .…”

Section: Discussionmentioning

confidence: 99%

“…17,18 OSA has been reported to be present in up to 78% of AF patients. 2,19 Aside from structurally induced changes due to chronic OSA, 20 such as atrial enlargement and increased fibrosis formation, there is a growing body of evidence supporting relevant acute and transient arrhythmogenic changes induced by single apneas or single nights of severe OSA. 6,8 In a recent observational study in OSApatients, the risk of having AF for at least 5 min during the day was increased and linked to suffering from severe OSA during the previous night, implying the importance of short-term OSA.…”

Section: Implications For Atrial Antiarrhythmic Drug Development In Osamentioning

confidence: 99%

See 1 more Smart Citation

Pharmacological inhibition of SK‐channels with AP14145 prevents atrial arrhythmogenic changes in a porcine model for obstructive respiratory events

Linz

Hesselkilde

Skarsfeldt

et al. 2022

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

Background Obstructive sleep apnea (OSA) creates a complex substrate for atrial fibrillation (AF), which is refractory to many clinically available pharmacological interventions. We investigated atrial antiarrhythmogenic properties and ventricular electrophysiological safety of small‐conductance Ca2+‐activated K+ (SK)‐channel inhibition in a porcine model for obstructive respiratory events. Methods In spontaneously breathing pigs, obstructive respiratory events were simulated by intermittent negative upper airway pressure (INAP) applied via a pressure device connected to the intubation tube. INAP was applied for 75 s, every 10 min, three times before and three times during infusion of the SK‐channel inhibitor AP14145. Atrial effective refractory periods (AERP) were acquired before (pre‐INAP), during (INAP) and after (post‐) INAP. AF‐inducibility was determined by a S1S2 atrial pacing protocol. Ventricular arrhythmicity was evaluated by heart rate adjusted QT‐interval duration (QT‐paced) and electromechanical window (EMW) shortening. Results During vehicle infusion, INAP transiently shortened AERP (pre‐INAP: 135 ± 10 ms vs. post‐INAP 101 ± 11 ms; p = .008) and increased AF‐inducibility. QT‐paced prolonged during INAP (pre‐INAP 270 ± 7 ms vs. INAP 275 ± 7 ms; p = .04) and EMW shortened progressively throughout INAP and post‐INAP (pre‐INAP 80 ± 4 ms; INAP 59 ± 6 ms, post‐INAP 46 ± 10 ms). AP14145 prolonged baseline AERP, partially prevented INAP‐induced AERP‐shortening and reduced AF‐susceptibility. AP14145 did not alter QT‐paced at baseline (pre‐AP14145 270 ± 7 ms vs. AP14145 268 ± 6 ms, p = .83) or QT‐paced and EMW‐shortening during INAP. Conclusion In a pig model for obstructive respiratory events, the SK‐channel‐inhibitor AP14145 prevented INAP‐associated AERP‐shortening and AF‐susceptibility without impairing ventricular electrophysiology. Whether SK‐channels represent a target for OSA‐related AF in humans warrants further study.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Implications For Atrial Antiarrhythmic Drug Development In Osamentioning

confidence: 99%

Pharmacological inhibition of SK‐channels with AP14145 prevents atrial arrhythmogenic changes in a porcine model for obstructive respiratory events

Linz

Hesselkilde

Skarsfeldt

et al. 2022

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…OSA may predispose to the development of AF both through its acute influence on autonomic tone and intrathoracic pressures, as well as through modulating chronic changes to the underlying atrial tissue substrate [16] . Not surprisingly the prevalence of moderate or greater severity OSA is as high as 40 % in patients with AF [17] , [18] , and similar to the prevalence of AF in patients with moderate-or-severe OSA [19] .…”

Section: Introductionmentioning

confidence: 60%

Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists

Faulx

Mehra²,

Geovanini³

et al. 2022

IJC Heart & Vasculature

View full text Add to dashboard Cite

“…Accordingly, SDB has been shown to increase the risk of both atrial and ventricular arrhythmia, as well as sudden cardiac death in HF patients [ 8 ]. There is growing evidence that the treatment of SDB can mitigate both the occurrence and recrudescence of atrial fibrillation, and supports rhythm stability [ 9 , 10 ]. Patients with symptomatic heart failure suffer from an impaired quality of life and an overall worse outcome, with a well-documented increased risk of ventricular arrhythmia [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Sleep-Disordered Breathing Treatment on Ventricular Tachycardia in Patients with Heart Failure

Gerçek

Gerçek²,

Alzein

et al. 2022

JCM

View full text Add to dashboard Cite

Background: Sleep-disordered breathing (SDB) is a highly common comorbidity in patients with heart failure (HF), and a known risk factor for ventricular tachycardia (VT) development. However, little is known about the impact of SDB treatment on VT burden in HF patients to date. Therefore, this study investigated VT burden, as well as implantable cardioverter-defibrillator (ICD) therapies in HF patients with SDB treatment, in comparison to untreated SDB HF patients. Methods: This retrospective study analyzed VT burden, rate of antitachycardia pacing (ATP), and the number of shocks delivered in a propensity score-matched patient cohort of patients with SDB treatment or control. Patients had moderate or severe SDB (n = 73 per each group; standardized mean difference of 0.08) and were followed for a minimum of one year. In addition, survival over 4 years was assessed. Results: Mean patient age was 67.67 ± 10.78 and 67.2 ± 10.10, respectively, with 15.06% and 10.95% of the patients, respectively, being female. Regarding SDB subtypes in the control and SDB treatment group, central sleep apnea was present in 42.46% and 41.09% of the patients, respectively, and obstructive sleep apnea was present in 26.02% and 31.50% of the patients, respectively. Mixed type sleep disorder was present in 31.50% and 27.40% of cases. Among the SDB treatment group, a significantly lower number of VTs (28.8% vs. 68.5%; p = 0.01), ATP (21.9% vs. 50.7%; p = 0.02), as well as a lower shock rate (5.5% vs. 31.5%; p < 0.01), was observed compared to the control group. Furthermore, the VT burden was significantly lower in the SDB treatment group when compared to the time prior to SDB treatment (p = 0.02). Event-free survival was significantly higher in the SDB treatment group (Log-rank p < 0.01). Conclusion: SDB treatment in HF patients with ICD leads to significant improvements in VT burden, ATP and shock therapy, and may even affect survival. Thus, HF patients should be generously screened for SDB and treated appropriately.

show abstract

Prevalence and Assessment of Sleep-Disordered Breathing in Patients With Atrial Fibrillation: A Systematic Review and Meta-analysis

Cited by 30 publications

References 55 publications

Pharmacological inhibition of SK‐channels with AP14145 prevents atrial arrhythmogenic changes in a porcine model for obstructive respiratory events

Pharmacological inhibition of SK‐channels with AP14145 prevents atrial arrhythmogenic changes in a porcine model for obstructive respiratory events

Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists

Impact of Sleep-Disordered Breathing Treatment on Ventricular Tachycardia in Patients with Heart Failure

Contact Info

Product

Resources

About