on May 12, 2003
Published online before print May 12, 2003, doi: 10.1161/01.CIR.0000068337.25994.21
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on December 31, 2002
From the Mayo Clinic, Rochester, Minn. * To whom correspondence should be addressed. E-mail: somers.virend{at}mayo.edu.
Background--We tested the hypothesis that patients with untreated obstructive sleep apnea (OSA) would be at increased risk for recurrence of atrial fibrillation (AF) after cardioversion. Methods and Results--We prospectively obtained data on history, echocardiogram, ECG, body mass index, hypertension, diabetes, NYHA functional class, ejection fraction, left atrial appendage velocity, and medications in patients with AF/atrial flutter referred for DC cardioversion. Forty-three individuals were identified as having OSA on the basis of a previous sleep study. Data regarding the use of continuous positive airway pressure (CPAP) and recurrence of AF were obtained for 39 of these patients. Follow-up data were also obtained in 79 randomly selected postcardioversion patients (controls) who did not have any previous sleep study. Twenty-seven of the 39 OSA patients either were not receiving any CPAP therapy (n=25) or were using CPAP inappropriately (n=2). Recurrence of AF at 12 months in these 27 patients was 82%, higher than the 42% recurrence in the treated OSA group (n=12, P=0.013) and the 53% recurrence (n=79, P=0.009) in the 79 control patients. Of the 25 OSA patients who had not been treated at all, the nocturnal fall in oxygen saturation was greater (P=0.034) in those who had recurrence of AF (n=20) than in those without recurrence (n=5). Conclusions--Patients with untreated OSA have a higher recurrence of AF after cardioversion than patients without a polysomnographic diagnosis of sleep apnea. Appropriate treatment with CPAP in OSA patients is associated with lower recurrence of AF.
Revised on February 27, 2003
Accepted on March 1, 2003
Obstructive Sleep Apnea and the Recurrence of Atrial Fibrillation
Ravi Kanagala MD,
Key words: fibrillation • sleep • apnea • cardioversion
This article has been cited by other articles:
 |
|
 |
|
  D. Hwang, N. Shakir, B. Limann, C. Sison, S. Kalra, L. Shulman, A. d. C. Souza, and H. Greenberg Association of Sleep-Disordered Breathing With Postoperative Complications Chest, May 1, 2008; 133(5): 1128 - 1134. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Baranchuk, C. S. Simpson, D. P. Redfearn, and M. Fitzpatrick It's time to wake up!: sleep apnea and cardiac arrhythmias Europace, April 7, 2008; (2008) eun078v1. [Full Text] [PDF]
|
|
|
|
 |
|
 J. T. Nguyen and D. G. Benditt Atrial Fibrillation Susceptibility in Metabolic Syndrome: Simply the Sum of Its Parts? Circulation, March 11, 2008; 117(10): 1249 - 1251. [Full Text] [PDF]
|
|
|
|
|
|
F. Lopez-Jimenez, F. H. Sert Kuniyoshi, A. Gami, and V. K. Somers Obstructive Sleep Apnea: Implications for Cardiac and Vascular Disease Chest, March 1, 2008; 133(3): 793 - 804. [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Golbin, V. K. Somers, and S. M. Caples Obstructive Sleep Apnea, Cardiovascular Disease, and Pulmonary Hypertension Proceedings of the ATS, February 15, 2008; 5(2): 200 - 206. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Amit Benjamin and K E Lewis Sleep-disordered breathing and cardiovascular disease Postgrad. Med. J., January 1, 2008; 84(987): 15 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. T. McNicholas Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2007; 293(4): R1666 - R1670. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Parati, C. Lombardi, and K. Narkiewicz Sleep apnea: epidemiology, pathophysiology, and relation to cardiovascular risk Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2007; 293(4): R1671 - R1683. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. K. Kakkar and R. B. Berry Positive Airway Pressure Treatment for Obstructive Sleep Apnea Chest, September 1, 2007; 132(3): 1057 - 1072. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Arias, A. M. Sanchez, A. Alonso-Fernandez, and F. Garcia-Rio Atrial Fibrillation, Obesity, and Obstructive Sleep Apnea Arch Intern Med, July 23, 2007; 167(14): 1552 - 1553. [Full Text] [PDF]
|
|
|
|
 |
|
 T Tanigawa, K Yamagishi, S Sakurai, I Muraki, H Noda, T Shimamoto, and H Iso Arterial oxygen desaturation during sleep and atrial fibrillation. Heart, December 1, 2006; 92(12): 1854 - 1855. [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Arias, A. M. Sanchez, J. M. Lopez, A. Alonso-Fernandez, and F. Garcia-Rio Clinical outcomes after direct current cardioversion of atrial tachyarrhythmias Eur. Heart J., July 2, 2006; 27(14): 1755 - 1755. [Full Text] [PDF]
|
|
|
|
|
|
A. A. Elesber, V. Somers, P. A. Friedman, and D. O. Hodge Clinical outcomes after direct current cardioversion of atrial tachyarrhythmias: reply Eur. Heart J., July 2, 2006; 27(14): 1755 - 1756. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Mehra, E. J. Benjamin, E. Shahar, D. J. Gottlieb, R. Nawabit, H. L. Kirchner, J. Sahadevan, and S. Redline Association of Nocturnal Arrhythmias with Sleep-disordered Breathing: The Sleep Heart Health Study Am. J. Respir. Crit. Care Med., April 15, 2006; 173(8): 910 - 916. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Vazir, M. Dayer, P. C. Hastings, H. F. McIntyre, M. Y. Henein, P. A. Poole-Wilson, M. R. Cowie, M. J. Morrell, and A. K. Simonds Can heart rate variation rule out sleep-disordered breathing in heart failure? Eur. Respir. J., March 1, 2006; 27(3): 571 - 577. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Kaw, F. Michota, A. Jaffer, S. Ghamande, D. Auckley, and J. Golish Unrecognized Sleep Apnea in the Surgical Patient: Implications for the Perioperative Setting Chest, January 1, 2006; 129(1): 198 - 205. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. K. Somers Sleep -- A New Cardiovascular Frontier N. Engl. J. Med., November 10, 2005; 353(19): 2070 - 2073. [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Caples, A. S. Gami, and V. K. Somers Obstructive Sleep Apnea Focus, October 1, 2005; 3(4): 557 - 567. [Full Text] [PDF]
|
|
|
|
|
|
M. A. Martinez-Garcia, R. Galiano-Blancart, P. Roman-Sanchez, J.-J. Soler-Cataluna, L. Cabero-Salt, and E. Salcedo-Maiques Continuous Positive Airway Pressure Treatment in Sleep Apnea Prevents New Vascular Events After Ischemic Stroke Chest, October 1, 2005; 128(4): 2123 - 2129. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Gersh, T. S.M. Tsang, M. E. Barnes, and J. B. Seward The changing epidemiology of non-valvular atrial fibrillation: the role of novel risk factors Eur. Heart J. Suppl., May 1, 2005; 7(suppl_C): C5 - C11. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Schulz, H J Eisele, and W Seeger Nocturnal atrial fibrillation in a patient with obstructive sleep apnoea Thorax, February 1, 2005; 60(2): 174 - 174. [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Caples, A. S. Gami, and V. K. Somers Obstructive Sleep Apnea Ann Intern Med, February 1, 2005; 142(3): 187 - 197. [Full Text] [PDF]
|
|
|
|
|
|
S. H. Feinsilver A Sleeping Giant: Sleep-Disordered Breathing in the Coronary Care Unit Chest, January 1, 2005; 127(1): 4 - 5. [Full Text] [PDF]
|
|
|
|
|
|
R. L. Page Newly Diagnosed Atrial Fibrillation N. Engl. J. Med., December 2, 2004; 351(23): 2408 - 2416. [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Wang, H. Parise, D. Levy, R. B. D'Agostino Sr, P. A. Wolf, R. S. Vasan, and E. J. Benjamin Obesity and the Risk of New-Onset Atrial Fibrillation JAMA, November 24, 2004; 292(20): 2471 - 2477. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. Gami, G. Pressman, S. M. Caples, R. Kanagala, J. J. Gard, D. E. Davison, J. F. Malouf, N. M. Ammash, P. A. Friedman, and V. K. Somers Association of Atrial Fibrillation and Obstructive Sleep Apnea Circulation, July 27, 2004; 110(4): 364 - 367. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. F. Quan and B. J. Gersh Cardiovascular Consequences of Sleep-Disordered Breathing: Past, Present and Future: Report of a Workshop From the National Center on Sleep Disorders Research and the National Heart, Lung, and Blood Institute Circulation, March 2, 2004; 109(8): 951 - 957. [Full Text] [PDF]
|
|
|
|
 |
|
 A. V. Chobanian, G. L. Bakris, H. R. Black, W. C. Cushman, L. A. Green, J. L. Izzo Jr, D. W. Jones, B. J. Materson, S. Oparil, J. T. Wright Jr, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Hypertension, December 1, 2003; 42(6): 1206 - 1252. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. M. Shamsuzzaman, B. J. Gersh, and V. K. Somers Obstructive Sleep Apnea: Implications for Cardiac and Vascular Disease JAMA, October 8, 2003; 290(14): 1906 - 1914. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 From the library Br. J. Ophthalmol., October 1, 2003; 87(10): 1308 - 1308. [Full Text] [PDF]
|
|