Baseline apnoea/hypopnoea index and high-sensitivity C-reactive protein for the risk of recurrence of atrial fibrillation after successful electrical cardioversion: a predictive model based upon the multiple effects of significant variables
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AIMS: We tested apnoea/hypopnoea index (AHI), high-sensitivity (hs) C-reactive protein and clinical/instrumental variables as predictors of atrial fibrillation (AF) recurrence over 1-year follow-up after successful electrical cardioversion. METHODS AND RESULTS: We enrolled 158 consecutive patients. Apnoea/hypopnoea index was assessed with standard overnight polysomnography and hs-C-reactive protein with immunonephelometry assay the day before electrical cardioversion. Atrial fibrillation recurrences occurred in 81 patients (51%). Predictors at univariate analysis were: AHI > or = 15 events/h (P = 0.001), hs-C-reactive protein >0.30 mg/dL (P = 0.009), AF duration >3 days (P = 0.008), diabetes (P = 0.03), and ongoing anti-arrhythmic therapy at the time of electrical cardioversion (P = 0.03). Survival analysis confirmed that patients with AHI > or = 15 events/h and hs-C-reactive protein > 0.30 mg/dL had a higher recurrence rate of AF (log rank P = 0.0006 and P = 0.01, respectively). Predictors at multivariate analysis were: AHI > or = 15 events/h (P = 0.003), hs-C-reactive protein > 0.30 mg/dL (P = 0.01) and ongoing anti-arrhythmic therapy (P = 0.04). A predictive model based upon the multiple effects of significant variables plus age as a continuous variable stratified the risk of AF recurrence, more than tripled with all dichotomized variables altered with respect to normal variables (85 vs. 27%). CONCLUSION: AHI > or = 15 events/h and hs-C-reactive protein > 0.30 mg/dL are the strongest predictors of the predictors chosen of AF recurrence after successful electrical cardioversion over 1-year follow-up.
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Moderate or severe OSA (AHI ≥15) is reported in 20%-62% of atrial fibrillation patients.
“Moderate or severe OSA (AHI ≥ 15) is reported in 20%–62%.330,704,706,710–715”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [714]
The ‘Sleep apnoea syndrome and risk of atrial fibrillation’ section reports moderate-to-severe sleep apnoea in 31% of 158 AF patients after successful cardioversion. That supports a prevalence within the cited range, but this paper does not establish the 20%–62% range or its endpoints. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn six studies that systematically assessed OSA before atrial fibrillation treatment, OSA was associated with an approximately two- to three-fold increased risk of recurrent atrial fibrillation following electrical cardioversion or pulmonary vein isolation.
“In six studies that systematically assessed the presence of OSA prior to treatment of AF, OSA was associated with an approximately two- to three-fold increased risk of recurrent AF following electrical cardioversion714 or pulmonary vein isolation (catheter ablation) procedures.708,709,711,713,727”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [714]
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- Authors
- Mazza, A., Bendini, M. G., Cristofori, M., Nardi, S., Leggio, M., De Cristofaro, R., Giordano, A., Cozzari, L., Giordano, G., & Cappato, R.
- Affiliations
- Azienda Ospedaliera S.Maria (IT)
- Ospedale San Filippo Neri (IT)
- University of Milan (IT)
- Corresponding author
- Leggio, M.
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-05-14
- Volume
- 11
- Issue
- 7
- Pages
- 902-909
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2124774684
- Semantic Scholar
- 5469bc33996f1dc8a12706fd9bde3a8cc7627f07
- Cited by
- 50
- References
- 47
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 2 · 2022: 5 · 2021: 4 · 2020: 4 · 2019: 1 · 2018: 5 · 2017: 4 · 2016: 2 · 2015: 1 · 2014: 7 · 2013: 1 · 2012: 2
- FWCI
- 2.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- atrial fibrillation recurrence, electrical cardioversion, apnea-hypopnea index, high-sensitivity C-reactive protein, sleep apnea, risk prediction model, antiarrhythmic therapy, AF duration, diabetes mellitus, polysomnography
- MeSH terms
- Adult, Aged, Atrial Fibrillation, C-Reactive Protein, Cardiac Pacing, Artificial, Female, Humans, Male, Recurrence, Risk Factors, Sensitivity and Specificity, Reproducibility of Results, Proportional Hazards Models, Treatment Outcome, Outcome Assessment, Health Care, Risk Assessment, Sleep Apnea, Obstructive
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