Ambulatory ECG predictors of atrial fibrillation are ineffective in severe sleep apnea

Abstract

Background: Obstructive sleep apnea (OSA) is strongly associated with atrial fibrillation (AF). Long-term ECG monitoring with implantable loop recorders facilitates the identification of undiagnosed AF in 20% of severe OSA cases. However, ambulatory ECG (AECG) monitoring is less resource intensive, and various parameters have been shown to predict AF. The aim of this study was to assess the efficacy of such AECGbased AF predictors in identifying patients with severe OSA most at risk. Methods: Prospective observational study including patients with severe OSA and no history of AF. Patients had two 24-hour AECG recordings, and if no AF was detected, implanted with a loop recorder (maximum 3 years). Results: Of 25 patients implanted, AF ≥ 10 seconds was detected in 5 patients. None of the parameters from the AECG recordings were significantly different between patients who did and did not develop AF. Conclusions: AECG-based parameters were not effective for the prediction of AF in this severe OSA cohort.

GJA1 Expression and Left Atrial Remodeling in the Incidence of Atrial Fibrillation in Patients with Obstructive Sleep Apnea Syndrome

“…There is a growing body of evidence suggesting that OSAS is considered a risk factor for AF [7]. The incidence of AF in OSAS patients varies from 7.6% to 20% in different studies investigating different populations and using different detection methods [7,9,10]. There are some reports on the relationship between AF and OSAS that show the incidence of AF is associated with OSAS severity, that AF patients with OSAS have a worse prognosis (a higher AF recurrence rate) whether receiving medication or ablation therapy [6,7] and that the treatment strategy (e.g., nasal continuous positive airway pressure) for OSAS may decrease the number of AF attacks [11].…”

Eight-Section Brocade Exercises Improve the Sleep Quality and Memory Consolidation and Cardiopulmonary Function of Older Adults With Atrial Fibrillation-Associated Stroke

“…We chose the baseline characteristics [age (Hokett and Duarte, 2019; Scullin et al, 2019), gender (Spencer, 2008), high blood pressure (Borda et al, 2019; Kumar et al, 2019), high blood lipids (Reijmer et al, 2009; Kruisbrink et al, 2017), diabetes (Margolis et al, 2019; Zhu et al, 2019), being overweight (Mora-Gonzalez et al, 2019; Yeo et al, 2019), atrial fibrillation (Takii et al, 2016; Yeung et al, 2019), smoking (Blaes et al, 2019; Cohen et al, 2019), family history of stroke (Baumann et al, 2012; Reeves et al, 2014), and history of transient ischemic attack (Takahashi et al, 2009; Sico et al, 2017)] according to previous reports indicating that these parameters would affect sleep and memory. The statistical difference for baseline characteristics was insignificant between the two groups (Table 1, p > 0.05).…”