Document Detail


Obstructive sleep apnea in patients with typical atrial flutter: prevalence and impact on arrhythmia control outcome.
MedLine Citation:
PMID:  23117936     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The clinical yield of cavotricuspid isthmus (CTI) radiofrequency ablation of atrial flutter (AF) is limited by a high incidence of atrial fibrillation (AFib) in the long term. Among other acknowledged variables, the association of obstructive sleep apnea (OSA) could favor incomplete arrhythmia control in this setting. We assessed the impact of CPAP in reducing the occurrence of AFib after CTI ablation.
METHODS: Consecutive patients with AF who were undergoing CTI ablation were screened for OSA. Relationship of the following variables with the occurrence of AFib during follow-up (12 months) was investigated: CPAP initiation, hypertension, BMI, underlying structural heart disease, left atrial diameter, and AFib documentation prior to ablation.
RESULTS: We prospectively included 56 patients (mean age: 66 (± 11) years; 12 female patients), of whom 46 (82%) had OSA and 25 (45%) had severe OSA. Twenty-one patients (38%) had AFib during follow-up after CTI ablation. Both freedom from AFib prior to ablation and CPAP initiation in those patients without previously documented AFib at inclusion were associated with a reduction of AFib episodes during follow-up (P = .019 and P = .025, respectively). Inversely, CPAP was not protective from AFib recurrence when this arrhythmia was documented prior to ablation (P = .25).
CONCLUSIONS: OSA is a prevalent condition in patients with AF. Treatment with CPAP is associated with a lower incidence of newly diagnosed AFib after CTI ablation. Screening for OSA in patients with AF appears to be a reasonable clinical strategy.
Authors:
Victor Bazan; Nuria Grau; Ermengol Valles; Miquel Felez; Carles Sanjuas; Miguel Cainzos-Achirica; Begoña Benito; Miguel Jauregui-Abularach; Joaquim Gea; Jordi Bruguera-Cortada; Julio Marti-Almor
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  143     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-10     Completed Date:  2013-08-29     Revised Date:  2013-12-24    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1277-83     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / epidemiology*,  physiopathology,  therapy*
Atrial Flutter / physiopathology,  surgery*
Body Mass Index
Catheter Ablation*
Continuous Positive Airway Pressure*
Female
Follow-Up Studies
Humans
Hypertension / epidemiology,  physiopathology
Incidence
Logistic Models
Male
Middle Aged
Multivariate Analysis
Prevalence
Prospective Studies
Sleep Apnea, Obstructive / epidemiology*,  physiopathology
Treatment Outcome
Comments/Corrections
Comment In:
Chest. 2013 Aug;144(2):713-4   [PMID:  23918127 ]
Chest. 2013 May;143(5):1198-9   [PMID:  23648900 ]
Chest. 2013 Aug;144(2):713   [PMID:  23918126 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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