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Low efficacy of atrial fibrillation ablation in severe obstructive sleep apnoea patients
Open accessAbstract
AIMS: Atrial fibrillation (AF) ablation efficacy varies according to patients' clinical characteristics. Although the association of obstructive sleep apnoea (OSA) and AF is well established, data on AF ablation efficacy in OSA are scarce. The aim of this study was to clarify the effect of OSA on the outcome of AF ablation. METHODS AND RESULTS: A series of 174 consecutive patients without polysomnography submitted to circumferential pulmonary vein ablation were included in the study. All patients were assessed by Berlin Questionnaire (BQ) and underwent an echocardiogram and a clinical evaluation. Patients with a high BQ score, indicating high risk for OSA, participated in a sleep study. Diagnoses were classified according to the apnoea-hypoapnoea index (AHI) as mild (AHI < 10/h), non-severe (AHI < 30/h), or severe (AHI >or= 30/h) OSA. Follow-up consisted of outpatient visits and 24 or 48 h Holter monitoring at 1, 4, and 7 months, and every 6 months thereafter. Any episode of AF or left atrial (LA) flutter was considered recurrence. Fifty-one (29.3%) patients had high BQ scores. The sleep study showed that 17 (9.8%) and 25 (14.4%) of these patients had non-severe and severe OSA, respectively. One-year arrhythmia-free probability after a single ablation procedure was 48.5% in patients with low risk for OSA (low BQ score or AHI < 10/h), 30.4% in the non-severe OSA group (10 < AHI < 30/h) and 14.3% in the severe OSA group (AHI >or= 30). Anteroposterior LA diameter [hazard ratio (HR) = 1.046, 95% confidence interval (CI): 1.005-1.089; P = 0.029] and severe OSA (HR = 1.870, 95% CI: 1.106-3.161; P = 0.019) were the independent predictors of arrhythmia recurrence. CONCLUSION: In patients with AF ablation, the presence of severe OSA is an independent predictor for AF ablation failure.
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“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 [727]
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Metadata
- Authors
- Matiello, M., Nadal, M., Tamborero, D., Berruezo, A., Montserrat, J., Embid, C., Rios, J., Villacastin, J., Brugada, J., & Mont, L.
- Affiliations
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
- Centro de Investigación Biomédica en Red (ES)
- Corresponding author
- Mont, L.
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-05-20
- Volume
- 12
- Issue
- 8
- Pages
- 1084-1089
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2039239562
- Semantic Scholar
- 121394d6faaf155a7b0fb8365c4ec5906770856a
- Cited by
- 156
- References
- 21
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 9 · 2023: 4 · 2022: 9 · 2021: 10 · 2020: 9 · 2019: 6 · 2018: 10 · 2017: 15 · 2016: 11 · 2015: 8 · 2014: 14 · 2013: 17 · 2012: 11
- FWCI
- 8.78
- 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 (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- atrial fibrillation, obstructive sleep apnea, pulmonary vein ablation, arrhythmia recurrence, Berlin questionnaire, left atrial diameter, predictors of recurrence, left atrial flutter, sleep apnea screening, catheter ablation outcomes
- MeSH terms
- Aged, Atrial Fibrillation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Recurrence, Risk Factors, Severity of Illness Index, Catheter Ablation, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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