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Journal of the American College of Cardiology: Clinical Electrophysiology

Clinical Articles, Lead Article

Atrial fibrillation recurrence lower with sleep apnoea treatment

The use of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnoea was associated with a significant reduction in the recurrence of atrial fibrillation, according to a study published recently in the Journal of the American College of Cardiology: Clinical Electrophysiology.1

Researchers performed a meta-analysis of seven studies including 1,087 patients. The analysis found that CPAP use was associated with a 58% relative risk reduction in atrial fibrillation recurrence in patients with obstructive sleep apnoea regardless of their primary treatment. While a large randomised trial still needs to be done, the researchers believe the data shows CPAP has potential to be a third treatment option for atrial fibrillation.

Previous studies evaluated the effect of CPAP use to reduce atrial fibrillation recurrence and suggested positive outcomes. However, these studies often had small sample sizes with varying results and there remained a need to comprehensively evaluate available data to determine the impact of CPAP use on atrial fibrillation, say the authors.

Dr Larry Chinitz (New York University School of Medicine)

Dr Larry Chinitz (New York University School of Medicine)

Speaking to BJC Arrhythmia Watch, co-author Dr Larry Chinitz (New York University School of Medicine) said: “Our study confirms the expanding body of evidence that treatment of modifiable risk factors has a significant impact on the long-term suppression of atrial fibrillation regardless of the type of therapy offered”.

“Active screening for obstructive sleep apnoea in all patients who undergo treatment for atrial fibrillation is imperative as the use of CPAP will influence the outcome of therapy and likely reduce some of the cardiovascular morbidity associated with atrial fibrillation…Technology for home screening of sleep apnoea needs to be made widely available and become as routine as measurements of blood pressure and HgA1C,” Dr Chinitz concluded.

References

1. Shukla A, Aizer A, Holmes D, et al. Effect of obstructive sleep apnea treatment on atrial fibrillation recurrence. JACCCEP 2015;1:41–51. http://dx.doi.org/10.1016/j.jacep.2015.02.014

Published on: May 28, 2015

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