The impact of continuous positive airway pressure treatment on the recurrence of atrial fibrillation post cardioversion: A randomized controlled trial

Caples, Sean M.; Mansukhani, Meghna P.; Friedman, Paul A.; Somers, Virend K.

doi:10.1016/j.ijcard.2018.11.100

Cited by 58 publications

(52 citation statements)

References 28 publications

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“…It should be recognized that no prospective clinical trials have proven a role for PAP therapy in improving rhythm outcomes. 60 • Stroke: A stroke or transient ischemic attack that occurs in a patient treated with PAP therapy for OSA should prompt follow-up evaluation and possible sleep apnea testing to ensure adequate control of sleep apnea and/or to rule out its presence, recognizing that patients are at risk for both obstructive and central sleep apnea.…”

Section: Clinical Guidance Statementsmentioning

confidence: 99%

Use of polysomnography and home sleep apnea tests for the longitudinal management of obstructive sleep apnea in adults: an American Academy of Sleep Medicine clinical guidance statement

Caples

Anderson

Calero

et al. 2021

Journal of Clinical Sleep Medicine

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Introduction: Obstructive sleep apnea is an important and common disorder with associated health risks. Assuring successful longitudinal management is vital to patient health and sleep-related quality of life. This paper provides guidance from the American Academy of Sleep Medicine (AASM) regarding the use of polysomnography (PSG) and home sleep apnea tests (HSATs) after a diagnosis of obstructive sleep apnea has been established and, in most cases, treatment implemented. Methods: The AASM commissioned a task force of five sleep medicine experts. A literature search was conducted to identify studies that included adult patients with OSA who underwent follow-up PSG or an HSAT. The task force developed clinical guidance statements based on a review of these studies and expert opinion. The AASM Board of Directors approved the final clinical guidance statements. Clinical Guidance Statements: The AASM supports the following clinical guidance statements on indications for follow-up PSG and HSAT in adult patients with OSA.1. Follow-up PSG or HSAT is not recommended for routine reassessment of asymptomatic patients with obstructive sleep apnea on PAP therapy, however, follow-up PSG or HSAT can be used to reassess patients with recurrent or persistent symptoms, despite good PAP adherence. 2. Follow-up PSG or HSAT is recommended to assess response to treatment with non-PAP interventions. 3. Follow-up PSG or HSAT may be used if clinically significant weight gain or loss has occurred since diagnosis of OSA or initiation of its treatment. 4. Follow-up PSG may be used for reassessment of sleep-related hypoxemia and/or sleep-related hypoventilation following initiation of treatment for OSA. 5. Follow-up PSG or HSAT may be used in patients being treated for OSA who develop or have a change in cardiovascular disease. 6. Follow-up PSG may be used in patients with unexplained PAP device-generated data. The ultimate judgment regarding propriety of any specific care must be made by the clinician, in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options and resources.

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Section: Clinical Guidance Statementsmentioning

confidence: 99%

Use of polysomnography and home sleep apnea tests for the longitudinal management of obstructive sleep apnea in adults: an American Academy of Sleep Medicine clinical guidance statement

Caples

Anderson

Calero

et al. 2021

Journal of Clinical Sleep Medicine

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“…Concomitant OSA increased (HR 2.61) and usage of CPAP therapy decreased (HR 0.41) the probability of AF recurrences in prospective study [ 91 ]. On the contrary, randomized controlled trial assessing the impact of treatment of OSA on recurrence of AF after direct current cardioversion (DCCV) did not detect a difference between those treated with PAP versus usual care [ 92 ].…”

Section: Endothelial Function After Treatment With Cpap In Specific Subgroupsmentioning

confidence: 99%

Cardiovascular Disorders Triggered by Obstructive Sleep Apnea—A Focus on Endothelium and Blood Components

Mochol

Gawryś

Gajecki

et al. 2021

IJMS

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Obstructive sleep apnea (OSA) is known to be an independent cardiovascular risk factor. Among arousal from sleep, increased thoracic pressure and enhanced sympathetic activation, intermittent hypoxia is now considered as one of the most important pathophysiological mechanisms contributing to the development of endothelial dysfunction. Nevertheless, not much is known about blood components, which justifies the current review. This review focuses on molecular mechanisms triggered by sleep apnea. The recurrent periods of hypoxemia followed by reoxygenation promote reactive oxygen species (ROS) overproduction and increase inflammatory response. In this review paper we also intend to summarize the effect of treatment with continuous positive airway pressure (CPAP) on changes in the profile of the endothelial function and its subsequent potential clinical advantage in lowering cardiovascular risk in other comorbidities such as diabetes, atherosclerosis, hypertension, atrial fibrillation. Moreover, this paper is aimed at explaining how the presence of OSA may affect platelet function and exert effects on rheological activity of erythrocytes, which could also be the key to explaining an increased risk of stroke.

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“…Aktuell wurde erstmals in einer kleinen randomisierten Studie geprüft, ob die Behandlung einer obstruktiven Schlafapnoe mittels CPAP-Therapie das Risiko eines VHF-Rezidivs nach elektrischer Kardioversion senkt (CPAP n = 12 und Kontrollen n = 13). Hinsichtlich der Rezidivrate (25 %) und der Zeitdauer bis zum Rezidiv des VHF (129 vs. 109 Tage) zeigte sich im Vergleich der CPAP-mit der Kontrollgruppe kein Unterschied [59]. Jedoch ist die Aussagekraft der Studie zum Beispiel aufgrund der geringen Fallzahlen nicht ausreichend, um einen Effekt der CPAP-Therapie auf das VHF-Rezidivrisiko nach Kardioversion auszuschließen.…”

Section: Rhythmuskontrolle Bei Sbas-patienten Mit Und Ohne Cpap-therapieunclassified

Interaktionen schlafbezogener Atmungsstörungen mit Vorhofflimmern

et al. 2020

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Zusammenfassung Hintergrund Vorhofflimmern (VHF) ist die häufigste Herzrhythmusstörung. Sowohl die zentrale als auch die obstruktive Schlafapnoe interagieren mit dieser Erkrankung. Intermittierende Hypoxie, oxidativer Stress, wiederkehrende Aufwachreaktionen, intrathorakale Druckveränderungen und atriales Remodeling können im Rahmen einer schlafbezogenen Atmungsstörung (SBAS) zu VHF führen. Ziel Dieser Artikel stellt die komplexen Zusammenhänge und Erkenntnisse jüngster Forschungen bezüglich SBAS und VHF sowie die Therapiemöglichkeiten dar. Material und Methoden Es erfolgten eine Literaturrecherche von Original- und Übersichtsartikeln sowie Metaanalysen, die zwischen 1963 und 2020 in der PubMed-Datenbank veröffentlicht wurden. Ergebnisse Die Erkenntnisse der Studien weisen auf einen bidirektionalen kausalen Zusammenhang zwischen SBAS und VHF hin. Die pathophysiologischen Auswirkungen der obstruktiven und zentralen Schlafapnoe auf VHF sind unterschiedlich. Die Studien, die die Effekte einer Therapie der SBAS auf das Rezidivrisiko von VHF nach Intervention (Kardioversion oder Pulmonalvenenisolation) untersuchen, ergeben bisher kein eindeutiges Bild. Diskussion Bisherige Studien bestätigen multiple Interaktionen zwischen SBAS und VHF. Aufgrund widersprüchlicher Ergebnisse hinsichtlich der Effekte einer positiven Atemwegsdrucktherapie auf das Rezidivrisiko von VHF nach Interventionen sind weitere Studien nötig.

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The impact of continuous positive airway pressure treatment on the recurrence of atrial fibrillation post cardioversion: A randomized controlled trial

Cited by 58 publications

References 28 publications

Use of polysomnography and home sleep apnea tests for the longitudinal management of obstructive sleep apnea in adults: an American Academy of Sleep Medicine clinical guidance statement

Use of polysomnography and home sleep apnea tests for the longitudinal management of obstructive sleep apnea in adults: an American Academy of Sleep Medicine clinical guidance statement

Cardiovascular Disorders Triggered by Obstructive Sleep Apnea—A Focus on Endothelium and Blood Components

Interaktionen schlafbezogener Atmungsstörungen mit Vorhofflimmern

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