Sleep Apnea and Atrial Fibrillation

Dominik Linz; Stanley Nattel; Jonathan M Kalman; Prashanthan Sanders

doi:10.1016/j.ccep.2020.10.003

Sleep Apnea and Atrial Fibrillation

Card Electrophysiol Clin. 2021 Mar;13(1):87-94. doi: 10.1016/j.ccep.2020.10.003.

Authors

Dominik Linz¹, Stanley Nattel², Jonathan M Kalman³, Prashanthan Sanders⁴

Affiliations

¹ Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia; Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute, Maastricht, the Netherlands; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address: Dominik.Linz@adelaide.edu.au.
² Department of Medicine, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada; Department of Pharmacology and Therapeutics, McGill University, 3655 Prom. Sir Willian Osler, Montreal, Quebec H3G 1Y6, Canada; Institute of Pharmacology, West German Heart and Vascular Center, Faculty of Medicine, University Duisburg-Essen, Essen, Germany.
³ Department of Cardiology, Royal Melbourne Hospital and Department of Medicine, University of Melbourne, 300 Grattan Street, Melbourne, Victoria, Australia.
⁴ Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.

PMID: 33516410
DOI: 10.1016/j.ccep.2020.10.003

Abstract

Obstructive sleep apnea (OSA) creates a complex and dynamic substrate for atrial fibrillation (AF), which is characterized by structural remodeling as a result of long-term OSA as well as transient and acute apnea-associated transient atrial electrophysiological changes. OSA is present in 21% to 74% of patients with AF, and nonrandomized studies suggest that treatment of OSA by continuous positive airway pressure may help to maintain sinus rhythm after electrical cardioversion and improve catheter ablation success rates. Management of OSA in patients with AF requires a close interdisciplinary collaboration between the electrophysiologist/cardiologist and sleep specialists.

Keywords: Atrial fibrillation; Continuous positive air pressure (CPAP); Polygraphy; Pulmonary vein isolation; Screening; Sleep apnea.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Atrial Fibrillation*
Catheter Ablation
Continuous Positive Airway Pressure
Humans
Sleep Apnea Syndromes*