Abstract 16025: Continuous Positive Airway Pressure Therapy as a Therapy for Cardiac Arrhythmias: Meta - Analysis of 14 Studies
Introduction: Obstructive sleep apnea (OSA) is a risk factor for cardiac arrhythmias. Continuous positive airway pressure (CPAP) as a therapy of these arrhythmias is not well established.
Hypothesis: We performed a meta-analysis of prospective cohort studies and randomized controlled trials to evaluate effect of CPAP on cardiac arrhythmias.
Methods: MEDLINE, EMBASE, Cochrane databases, GoogleScholar and WebofScience from inception to June 2014 were searched for prospective cohort and intervention studies reporting that had CPAP as intervention and cardiac arrhythmia as an outcome measure. Two authors independently assessed study quality and extracted data. Random effects model was used to estimate pooled effect of CPAP on burden as well as number of events of cardiac arrhythmias. Between-study heterogeneity was assessed by I2 method.
Results: Ten prospective cohort studies and four randomized controlled trials were included. There were a total of 1246 individuals that underwent CPAP therapy and 1213 were in comparison group. In random-effect models, CPAP was associated with decreased risk of cardiac arrhythmia (pooled Risk Ratio 0.62; 95% CI 0.41 - 0.93, p = 0.02) as well as burden of cardiac arrhythmia (mean difference in electrocardiographic abnormality -14.6; 95% CI -23.6 - -5.7, p = 0.002). Significant heterogeneity was present in studies (I2 = >90%). Type of cardiac arrhythmia (atrial vs. ventricular) explained most of the heterogeneity; with greater effect of CPAP on reducing atrial rather than ventricular arrhythmia. Forest plots are given in the figure.
Conclusions: CPAP appears to be effective in treatment of cardiac arrhythmia in OSA patients. The effect is greater for atrial arrhythmia than ventricular arrhythmia. Long term studies evaluating this effect on mortality are needed.
Author Disclosures: W. Qureshi: None. U.B. Nasir: None. Z. Ali: None. S. Qadir: None. M.K. Hayat-Syed: None. S. Alqalyoobi: None. S. Mawri: None. M.H. Al-Mallah: None.
- © 2014 by American Heart Association, Inc.