Abstract 3511: Left Atrial Radiofrequency Ablation for Atrial Fibrillation in Patients with Obstructive Sleep Apnea
Background: It has been suggested that obstructive sleep apnea (OSA) may be associated with development of atrial fibrillation (AF). However, the mechanism of this association has been unclear, and it is not known whether left atrial radiofrequency ablation (LARFA) has a similar efficacy in patients with and without OSA.
Methods and Results: In 684 consecutive patients (mean age=56±11 years) LARFA was performed to eliminate paroxysmal (438) or chronic AF (246). OSA was diagnosed prior to ablation in 65 patients (10%). AF was chronic in 57% (37/65) and 34% (209/619) of the patients with and without OSA, respectively (P<0.01). During a mean follow-up of 24±8 months, among the 438 patients with paroxysmal AF, 17 of the 28 patients with OSA (61%) and 305 of the 410 patients without OSA (74%) were free from recurrent AF or flutter without antiarrhythmic drugs (P=0.1). Among the 246 patients with chronic AF, 19 of the 37 patients with OSA (51%) and 135 of the 209 patients without OSA (65%) were free from recurrent AF or flutter without antiarrhythmic drugs (P=0.1). Among the clinical variables of whether AF was paroxysmal or chronic, gender, age > 65 years, left atrial diameter (LA) >40 mm, OSA, and left ventricular ejection fraction, chronic AF, LA >40 mm, gender and OSA (OR: 1.72 ±95% CI:1.00–2.93, P<0.05) were independent predictors of recurrent arrhythmias after LARFA. Pericardial tamponade occurred in 0.5% of patients without OSA. There were no complications in patients with OSA.
Conclusions: Although LARFA is safe in patients with OSA, and OSA appears to be an independent predictor of recurrences. It is possible that mechanisms other than those eliminated by LARFA may continue to be operative in patients with OSA after LARFA.