TY - JOUR
T1 - Sleep apnea and atrial fibrillation
T2 - challenges in clinical and translational research
AU - Linz, Benedikt
AU - Norup Hertel, Julie
AU - Hendriks, Jeroen
AU - Saljic, Arnela
AU - Dobrev, Dobromir
AU - Baumert, Mathias
AU - Jespersen, Thomas
AU - Linz, Dominik
PY - 2022
Y1 - 2022
N2 - Introduction: Sleep-disordered breathing (SDB) is present in 21–74% of all patients with atrial fibrillation (AF). Treatment of SDB by positive airway pressure may help to prevent recurrence of AF after electrical cardioversion and help to improve AF ablation success rates in non-randomized studies. Areas covered: In this review, the current understanding of the atrial arrhythmogenic pathophysiology of SDB is summarized, and diagnostic and therapeutic challenges in AF patients are discussed. Current international recommendations are presented, and a comprehensive literature search is undertaken. Expert opinion: AF patients with SDB rarely report SDB-related symptoms such as daytime sleepiness. Therefore, systematic home sleep testing evaluation should be considered for all patients eligible for rhythm control strategy. A close interdisciplinary collaboration between the electrophysiologist/cardiologist, nurses and sleep-specialists are required for the management of SDB in AF patients. An arrhythmia-orientated assessment of SDB may better quantify SDB-related AF risk in an individual patient and may help to better guide targeted and personalized SDB treatment in AF patients as a component of rhythm and symptom control strategies. Finally, randomized controlled trials are needed to confirm the relationship between SDB and AF, and the benefits of routine testing and treatment of SDB in AF patients.
AB - Introduction: Sleep-disordered breathing (SDB) is present in 21–74% of all patients with atrial fibrillation (AF). Treatment of SDB by positive airway pressure may help to prevent recurrence of AF after electrical cardioversion and help to improve AF ablation success rates in non-randomized studies. Areas covered: In this review, the current understanding of the atrial arrhythmogenic pathophysiology of SDB is summarized, and diagnostic and therapeutic challenges in AF patients are discussed. Current international recommendations are presented, and a comprehensive literature search is undertaken. Expert opinion: AF patients with SDB rarely report SDB-related symptoms such as daytime sleepiness. Therefore, systematic home sleep testing evaluation should be considered for all patients eligible for rhythm control strategy. A close interdisciplinary collaboration between the electrophysiologist/cardiologist, nurses and sleep-specialists are required for the management of SDB in AF patients. An arrhythmia-orientated assessment of SDB may better quantify SDB-related AF risk in an individual patient and may help to better guide targeted and personalized SDB treatment in AF patients as a component of rhythm and symptom control strategies. Finally, randomized controlled trials are needed to confirm the relationship between SDB and AF, and the benefits of routine testing and treatment of SDB in AF patients.
KW - Atrial fibrillation
KW - CPAP
KW - polygraphy
KW - pulmonary vein isolation
KW - screening
KW - sleep apnea
UR - http://www.scopus.com/inward/record.url?scp=85125245799&partnerID=8YFLogxK
U2 - 10.1080/14779072.2022.2036606
DO - 10.1080/14779072.2022.2036606
M3 - Article
C2 - 35094618
AN - SCOPUS:85125245799
VL - 20
SP - 101
EP - 109
JO - Expert Review of Cardiovascular Therapy
JF - Expert Review of Cardiovascular Therapy
SN - 1477-9072
IS - 2
ER -