Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation: Clinical impact of continuous positive airway pressure therapy
Background Recent studies have suggested an emerging link between obstructive sleep apnea (OSA) and atrial fibrillation (AF). Patients with OSA are less likely to remain in sinus rhythm after radiofrequency catheter ablation of AF. Objective To evaluate the efficacy of appropriate treatment with con...
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| Veröffentlicht in: | Heart rhythm 2013-03, Vol.10 (3), p.331-337 |
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| creator | Naruse, Yoshihisa, MD Tada, Hiroshi, MD, FHRS Satoh, Makoto, MD Yanagihara, Mariko, MD Tsuneoka, Hidekazu, MD Hirata, Yumi, PhD Ito, Yoko, MD Kuroki, Kenji, MD Machino, Takeshi, MD Yamasaki, Hiro, MD Igarashi, Miyako, MD Sekiguchi, Yukio, MD Sato, Akira, MD Aonuma, Kazutaka, MD |
| description | Background Recent studies have suggested an emerging link between obstructive sleep apnea (OSA) and atrial fibrillation (AF). Patients with OSA are less likely to remain in sinus rhythm after radiofrequency catheter ablation of AF. Objective To evaluate the efficacy of appropriate treatment with continuous positive airway pressure (CPAP) on recurrences of AF after ablation. Methods This study prospectively included 153 patients (128 men; 60±9 years) who underwent extensive encircling pulmonary vein isolation for drug refractory AF. The standard overnight polysomnographic evaluation was performed 1 week after ablation, and the total duration and the number of central or obstructive sleep apnea or hypopnea episodes were examined. Results Of 153 patients, 116 patients were identified as having OSA. Data regarding the use of CPAP and recurrences of AF were obtained in 82 patients. The remaining 34 patients with OSA were defined as the no-CPAP group. Polysomnography revealed no sleep-disordered breathing in 37 patients. During a mean follow-up period of 18.8±10.3 months, 51 (33%) patients experienced AF recurrences after ablation. A Cox regression analysis revealed that the left atrial volume (hazard ratio [HR] 1.11; 95% confidence interval [CI] 1.01–1.23; P |
| doi_str_mv | 10.1016/j.hrthm.2012.11.015 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1314333417</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S1547527112013665</els_id><sourcerecordid>1314333417</sourcerecordid><originalsourceid>FETCH-LOGICAL-c480t-edf7acc3a465998a44d0e8ef70483aff38ffd82961d0a061f3808bd475cd05f33</originalsourceid><addsrcrecordid>eNqFktuKFDEQhhtR3HX1CQTJpTczJp0-jaAggydY8EK9DjXpilNjd9JW0rvMg_o-pndGL0TwKqH46q_DX0XxVMm1kqp5cVjvOe3HdSlVuVZqLVV9r7hUdd2sdNeq-8u_ald12aqL4lGMBynLTSP1w-Ki1Krtmq69LH5ug7dhpAQ-ibCLiWeb6AZFHBAnAZNHEOQtI0SMIu1RMNqZGb1FEZyAxASDcLRjGgZIFLxwYRjCLflvgqGn4Bh_zJk_CgtZICEL2J3Rfyu8FNuBPNkcpnECmxbOBp_Iz2GOYgqR7roE4ls4iokxxplx6Y9hOj4uHjgYIj45v1fF13dvv2w_rK4_vf-4fXO9slUn0wp714K1Gqqm3mw6qKpeYoeulVWnwTndOdd3eWmqlyAblQOy2_VVW9te1k7rq-L5SXfikEeMyYwULeYpPOY-jdKq0lpXqs2oPqGWQ4yMzkxMI_DRKGkWP83B3PlpFj-NUib7mbOenQvMuxH7Pzm_DczAqxOAecwbQjbR0uJNT9mnZPpA_ynw-q98e978dzxiPISZfd6gUSaWRprPy0ktF6WyiG6aWv8CJQnPpQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1314333417</pqid></control><display><type>article</type><title>Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation: Clinical impact of continuous positive airway pressure therapy</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Naruse, Yoshihisa, MD ; Tada, Hiroshi, MD, FHRS ; Satoh, Makoto, MD ; Yanagihara, Mariko, MD ; Tsuneoka, Hidekazu, MD ; Hirata, Yumi, PhD ; Ito, Yoko, MD ; Kuroki, Kenji, MD ; Machino, Takeshi, MD ; Yamasaki, Hiro, MD ; Igarashi, Miyako, MD ; Sekiguchi, Yukio, MD ; Sato, Akira, MD ; Aonuma, Kazutaka, MD</creator><creatorcontrib>Naruse, Yoshihisa, MD ; Tada, Hiroshi, MD, FHRS ; Satoh, Makoto, MD ; Yanagihara, Mariko, MD ; Tsuneoka, Hidekazu, MD ; Hirata, Yumi, PhD ; Ito, Yoko, MD ; Kuroki, Kenji, MD ; Machino, Takeshi, MD ; Yamasaki, Hiro, MD ; Igarashi, Miyako, MD ; Sekiguchi, Yukio, MD ; Sato, Akira, MD ; Aonuma, Kazutaka, MD</creatorcontrib><description>Background Recent studies have suggested an emerging link between obstructive sleep apnea (OSA) and atrial fibrillation (AF). Patients with OSA are less likely to remain in sinus rhythm after radiofrequency catheter ablation of AF. Objective To evaluate the efficacy of appropriate treatment with continuous positive airway pressure (CPAP) on recurrences of AF after ablation. Methods This study prospectively included 153 patients (128 men; 60±9 years) who underwent extensive encircling pulmonary vein isolation for drug refractory AF. The standard overnight polysomnographic evaluation was performed 1 week after ablation, and the total duration and the number of central or obstructive sleep apnea or hypopnea episodes were examined. Results Of 153 patients, 116 patients were identified as having OSA. Data regarding the use of CPAP and recurrences of AF were obtained in 82 patients. The remaining 34 patients with OSA were defined as the no-CPAP group. Polysomnography revealed no sleep-disordered breathing in 37 patients. During a mean follow-up period of 18.8±10.3 months, 51 (33%) patients experienced AF recurrences after ablation. A Cox regression analysis revealed that the left atrial volume (hazard ratio [HR] 1.11; 95% confidence interval [CI] 1.01–1.23; P <.05), concomitant OSA (HR 2.61; 95% CI 1.12–6.09; P <.05), and usage of CPAP therapy (HR 0.41; 95% CI 0.22–0.76; P <.01) were associated with AF recurrences during the follow-up period. Conclusions Patients with untreated OSA have a higher recurrence of AF after ablation. Appropriate treatment with CPAP in patients with OSA is associated with a lower recurrence of AF.</description><identifier>ISSN: 1547-5271</identifier><identifier>EISSN: 1556-3871</identifier><identifier>DOI: 10.1016/j.hrthm.2012.11.015</identifier><identifier>PMID: 23178687</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Atrial fibrillation ; Atrial Fibrillation - complications ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - surgery ; Cardiovascular ; Catheter Ablation ; Continuous Positive Airway Pressure - methods ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Obstructive sleep apnea ; Polysomnography ; Prognosis ; Prospective Studies ; Recurrence ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - physiopathology ; Sleep Apnea, Obstructive - therapy</subject><ispartof>Heart rhythm, 2013-03, Vol.10 (3), p.331-337</ispartof><rights>Heart Rhythm Society</rights><rights>2013 Heart Rhythm Society</rights><rights>Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c480t-edf7acc3a465998a44d0e8ef70483aff38ffd82961d0a061f3808bd475cd05f33</citedby><cites>FETCH-LOGICAL-c480t-edf7acc3a465998a44d0e8ef70483aff38ffd82961d0a061f3808bd475cd05f33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1547527112013665$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23178687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Naruse, Yoshihisa, MD</creatorcontrib><creatorcontrib>Tada, Hiroshi, MD, FHRS</creatorcontrib><creatorcontrib>Satoh, Makoto, MD</creatorcontrib><creatorcontrib>Yanagihara, Mariko, MD</creatorcontrib><creatorcontrib>Tsuneoka, Hidekazu, MD</creatorcontrib><creatorcontrib>Hirata, Yumi, PhD</creatorcontrib><creatorcontrib>Ito, Yoko, MD</creatorcontrib><creatorcontrib>Kuroki, Kenji, MD</creatorcontrib><creatorcontrib>Machino, Takeshi, MD</creatorcontrib><creatorcontrib>Yamasaki, Hiro, MD</creatorcontrib><creatorcontrib>Igarashi, Miyako, MD</creatorcontrib><creatorcontrib>Sekiguchi, Yukio, MD</creatorcontrib><creatorcontrib>Sato, Akira, MD</creatorcontrib><creatorcontrib>Aonuma, Kazutaka, MD</creatorcontrib><title>Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation: Clinical impact of continuous positive airway pressure therapy</title><title>Heart rhythm</title><addtitle>Heart Rhythm</addtitle><description>Background Recent studies have suggested an emerging link between obstructive sleep apnea (OSA) and atrial fibrillation (AF). Patients with OSA are less likely to remain in sinus rhythm after radiofrequency catheter ablation of AF. Objective To evaluate the efficacy of appropriate treatment with continuous positive airway pressure (CPAP) on recurrences of AF after ablation. Methods This study prospectively included 153 patients (128 men; 60±9 years) who underwent extensive encircling pulmonary vein isolation for drug refractory AF. The standard overnight polysomnographic evaluation was performed 1 week after ablation, and the total duration and the number of central or obstructive sleep apnea or hypopnea episodes were examined. Results Of 153 patients, 116 patients were identified as having OSA. Data regarding the use of CPAP and recurrences of AF were obtained in 82 patients. The remaining 34 patients with OSA were defined as the no-CPAP group. Polysomnography revealed no sleep-disordered breathing in 37 patients. During a mean follow-up period of 18.8±10.3 months, 51 (33%) patients experienced AF recurrences after ablation. A Cox regression analysis revealed that the left atrial volume (hazard ratio [HR] 1.11; 95% confidence interval [CI] 1.01–1.23; P <.05), concomitant OSA (HR 2.61; 95% CI 1.12–6.09; P <.05), and usage of CPAP therapy (HR 0.41; 95% CI 0.22–0.76; P <.01) were associated with AF recurrences during the follow-up period. Conclusions Patients with untreated OSA have a higher recurrence of AF after ablation. Appropriate treatment with CPAP in patients with OSA is associated with a lower recurrence of AF.</description><subject>Atrial fibrillation</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Cardiovascular</subject><subject>Catheter Ablation</subject><subject>Continuous Positive Airway Pressure - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Obstructive sleep apnea</subject><subject>Polysomnography</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - physiopathology</subject><subject>Sleep Apnea, Obstructive - therapy</subject><issn>1547-5271</issn><issn>1556-3871</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFktuKFDEQhhtR3HX1CQTJpTczJp0-jaAggydY8EK9DjXpilNjd9JW0rvMg_o-pndGL0TwKqH46q_DX0XxVMm1kqp5cVjvOe3HdSlVuVZqLVV9r7hUdd2sdNeq-8u_ald12aqL4lGMBynLTSP1w-Ki1Krtmq69LH5ug7dhpAQ-ibCLiWeb6AZFHBAnAZNHEOQtI0SMIu1RMNqZGb1FEZyAxASDcLRjGgZIFLxwYRjCLflvgqGn4Bh_zJk_CgtZICEL2J3Rfyu8FNuBPNkcpnECmxbOBp_Iz2GOYgqR7roE4ls4iokxxplx6Y9hOj4uHjgYIj45v1fF13dvv2w_rK4_vf-4fXO9slUn0wp714K1Gqqm3mw6qKpeYoeulVWnwTndOdd3eWmqlyAblQOy2_VVW9te1k7rq-L5SXfikEeMyYwULeYpPOY-jdKq0lpXqs2oPqGWQ4yMzkxMI_DRKGkWP83B3PlpFj-NUib7mbOenQvMuxH7Pzm_DczAqxOAecwbQjbR0uJNT9mnZPpA_ynw-q98e978dzxiPISZfd6gUSaWRprPy0ktF6WyiG6aWv8CJQnPpQ</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Naruse, Yoshihisa, MD</creator><creator>Tada, Hiroshi, MD, FHRS</creator><creator>Satoh, Makoto, MD</creator><creator>Yanagihara, Mariko, MD</creator><creator>Tsuneoka, Hidekazu, MD</creator><creator>Hirata, Yumi, PhD</creator><creator>Ito, Yoko, MD</creator><creator>Kuroki, Kenji, MD</creator><creator>Machino, Takeshi, MD</creator><creator>Yamasaki, Hiro, MD</creator><creator>Igarashi, Miyako, MD</creator><creator>Sekiguchi, Yukio, MD</creator><creator>Sato, Akira, MD</creator><creator>Aonuma, Kazutaka, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130301</creationdate><title>Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation: Clinical impact of continuous positive airway pressure therapy</title><author>Naruse, Yoshihisa, MD ; Tada, Hiroshi, MD, FHRS ; Satoh, Makoto, MD ; Yanagihara, Mariko, MD ; Tsuneoka, Hidekazu, MD ; Hirata, Yumi, PhD ; Ito, Yoko, MD ; Kuroki, Kenji, MD ; Machino, Takeshi, MD ; Yamasaki, Hiro, MD ; Igarashi, Miyako, MD ; Sekiguchi, Yukio, MD ; Sato, Akira, MD ; Aonuma, Kazutaka, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c480t-edf7acc3a465998a44d0e8ef70483aff38ffd82961d0a061f3808bd475cd05f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Atrial fibrillation</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Cardiovascular</topic><topic>Catheter Ablation</topic><topic>Continuous Positive Airway Pressure - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Obstructive sleep apnea</topic><topic>Polysomnography</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Sleep Apnea, Obstructive - complications</topic><topic>Sleep Apnea, Obstructive - physiopathology</topic><topic>Sleep Apnea, Obstructive - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Naruse, Yoshihisa, MD</creatorcontrib><creatorcontrib>Tada, Hiroshi, MD, FHRS</creatorcontrib><creatorcontrib>Satoh, Makoto, MD</creatorcontrib><creatorcontrib>Yanagihara, Mariko, MD</creatorcontrib><creatorcontrib>Tsuneoka, Hidekazu, MD</creatorcontrib><creatorcontrib>Hirata, Yumi, PhD</creatorcontrib><creatorcontrib>Ito, Yoko, MD</creatorcontrib><creatorcontrib>Kuroki, Kenji, MD</creatorcontrib><creatorcontrib>Machino, Takeshi, MD</creatorcontrib><creatorcontrib>Yamasaki, Hiro, MD</creatorcontrib><creatorcontrib>Igarashi, Miyako, MD</creatorcontrib><creatorcontrib>Sekiguchi, Yukio, MD</creatorcontrib><creatorcontrib>Sato, Akira, MD</creatorcontrib><creatorcontrib>Aonuma, Kazutaka, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Heart rhythm</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Naruse, Yoshihisa, MD</au><au>Tada, Hiroshi, MD, FHRS</au><au>Satoh, Makoto, MD</au><au>Yanagihara, Mariko, MD</au><au>Tsuneoka, Hidekazu, MD</au><au>Hirata, Yumi, PhD</au><au>Ito, Yoko, MD</au><au>Kuroki, Kenji, MD</au><au>Machino, Takeshi, MD</au><au>Yamasaki, Hiro, MD</au><au>Igarashi, Miyako, MD</au><au>Sekiguchi, Yukio, MD</au><au>Sato, Akira, MD</au><au>Aonuma, Kazutaka, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation: Clinical impact of continuous positive airway pressure therapy</atitle><jtitle>Heart rhythm</jtitle><addtitle>Heart Rhythm</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>10</volume><issue>3</issue><spage>331</spage><epage>337</epage><pages>331-337</pages><issn>1547-5271</issn><eissn>1556-3871</eissn><abstract>Background Recent studies have suggested an emerging link between obstructive sleep apnea (OSA) and atrial fibrillation (AF). Patients with OSA are less likely to remain in sinus rhythm after radiofrequency catheter ablation of AF. Objective To evaluate the efficacy of appropriate treatment with continuous positive airway pressure (CPAP) on recurrences of AF after ablation. Methods This study prospectively included 153 patients (128 men; 60±9 years) who underwent extensive encircling pulmonary vein isolation for drug refractory AF. The standard overnight polysomnographic evaluation was performed 1 week after ablation, and the total duration and the number of central or obstructive sleep apnea or hypopnea episodes were examined. Results Of 153 patients, 116 patients were identified as having OSA. Data regarding the use of CPAP and recurrences of AF were obtained in 82 patients. The remaining 34 patients with OSA were defined as the no-CPAP group. Polysomnography revealed no sleep-disordered breathing in 37 patients. During a mean follow-up period of 18.8±10.3 months, 51 (33%) patients experienced AF recurrences after ablation. A Cox regression analysis revealed that the left atrial volume (hazard ratio [HR] 1.11; 95% confidence interval [CI] 1.01–1.23; P <.05), concomitant OSA (HR 2.61; 95% CI 1.12–6.09; P <.05), and usage of CPAP therapy (HR 0.41; 95% CI 0.22–0.76; P <.01) were associated with AF recurrences during the follow-up period. Conclusions Patients with untreated OSA have a higher recurrence of AF after ablation. Appropriate treatment with CPAP in patients with OSA is associated with a lower recurrence of AF.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23178687</pmid><doi>10.1016/j.hrthm.2012.11.015</doi><tpages>7</tpages></addata></record> |
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| subjects | Atrial fibrillation Atrial Fibrillation - complications Atrial Fibrillation - epidemiology Atrial Fibrillation - surgery Cardiovascular Catheter Ablation Continuous Positive Airway Pressure - methods Female Follow-Up Studies Humans Incidence Male Middle Aged Obstructive sleep apnea Polysomnography Prognosis Prospective Studies Recurrence Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - physiopathology Sleep Apnea, Obstructive - therapy |
| title | Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation: Clinical impact of continuous positive airway pressure therapy |
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