Cited by 983Obstructive Sleep Apnea ResearchAtrial Fibrillation Management and OutcomesCardiovascular and Diving-Related Complications

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Obstructive Sleep Apnea and the Recurrence of Atrial Fibrillation

Kanagala, Ravi, Murali, Narayana S., Friedman, Paul A., Ammash, Naser M., Gersh, Bernard J., Ballman, Karla V., M. Shamsuzzaman, Abu S., Somers, Virend K.·2003·Circulation

DOI 10.1161/01.cir.0000068337.25994.21

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Abstract

Background— We tested the hypothesis that patients with untreated obstructive sleep apnea (OSA) would be at increased risk for recurrence of atrial fibrillation (AF) after cardioversion. Methods and Results— We prospectively obtained data on history, echocardiogram, ECG, body mass index, hypertension, diabetes, NYHA functional class, ejection fraction, left atrial appendage velocity, and medications in patients with AF/atrial flutter referred for DC cardioversion. Forty-three individuals were identified as having OSA on the basis of a previous sleep study. Data regarding the use of continuous positive airway pressure (CPAP) and recurrence of AF were obtained for 39 of these patients. Follow-up data were also obtained in 79 randomly selected postcardioversion patients (controls) who did not have any previous sleep study. Twenty-seven of the 39 OSA patients either were not receiving any CPAP therapy (n=25) or were using CPAP inappropriately (n=2). Recurrence of AF at 12 months in these 27 patients was 82%, higher than the 42% recurrence in the treated OSA group (n=12, P =0.013) and the 53% recurrence (n=79, P =0.009) in the 79 control patients. Of the 25 OSA patients who had not been treated at all, the nocturnal fall in oxygen saturation was greater ( P =0.034) in those who had recurrence of AF (n=20) than in those without recurrence (n=5). Conclusions— Patients with untreated OSA have a higher recurrence of AF after cardioversion than patients without a polysomnographic diagnosis of sleep apnea. Appropriate treatment with CPAP in OSA patients is associated with lower recurrence of AF.

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Authors: Kanagala, R., Murali, N. S., Friedman, P. A., Ammash, N. M., Gersh, B. J., Ballman, K. V., M. Shamsuzzaman, A. S., & Somers, V. K.
Affiliations: Mayo Clinic (US)
From the Mayo Clinic, Rochester, Minn.
ORCID: Murali, Narayana S.
Friedman, Paul A.
Gersh, Bernard J.
Ballman, Karla V.
Somers, Virend K.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2003-05-27
Volume: 107
Issue: 20
Pages: 2589-2594
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.0000068337.25994.21
OpenAlex: W2166034725
Semantic Scholar: 4d1d8e2eb0eec2b17a912f1a22e27d1c59944409
Cited by: 983
References: 27
Citations by year: 2026: 22 · 2025: 30 · 2024: 21 · 2023: 29 · 2022: 36 · 2021: 42 · 2020: 46 · 2019: 38 · 2018: 55 · 2017: 63 · 2016: 44 · 2015: 66 · 2014: 55 · 2013: 66 · 2012: 54
FWCI: 15.72
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: American Heart Association
Dana Foundation
National Institutes of Health (65176, RR-00585)
National Heart, Lung, and Blood Institute (HL65176, R01HL065176, HL70602, HL61560, R01HL061560)
National Center for Research Resources (M01-RR00 585, M01RR000585)
Topics: Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
Keywords: obstructive sleep apnea, atrial fibrillation recurrence, atrial flutter, electrical cardioversion, continuous positive airway pressure, CPAP therapy, nocturnal hypoxemia, polysomnography, left atrial appendage
MeSH terms: Aged, Atrial Fibrillation, Atrial Flutter, Diabetes Mellitus, Electric Countershock, Electrocardiography, Female, Follow-Up Studies, Humans, Hypertension, Male, Middle Aged, Minnesota, Oximetry, Positive-Pressure Respiration, Prospective Studies, Surveys and Questionnaires, Recurrence, Sleep, Comorbidity, Body Mass Index, Risk Assessment, Sleep Apnea, Obstructive

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Obstructive Sleep Apnea and the Recurrence of Atrial Fibrillation

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