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Occult obstructive sleep apnea and clinical outcomes of radiofrequency catheter ablation in patients with atrial fibrillation

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Recurrent atrial fibrillation (AF) after successful cardioversion can be predicted by obstructive sleep apnea (OSA) diagnosed by polysomnography. However, it is not known whether the validated STOP-BANG questionnaire can predict AF recurrence after radiofrequency ablation (RFA). Our objective is to determine the prevalence of unrecognized OSA in patients with AF and its relation to freedom from AF after RFA.

Methods

Validated surveys were administered to 247 consecutive AF patients following radiofrequency ablation from January to October 2011. OSA status was assessed at baseline RFA. Clinical follow up occurred at 3-6 month intervals.

Results

OSA had been previously diagnosed in 94/247 (38%). Among 153 patients without prior diagnosis of OSA, 121 (79%) had high risk STOP-BANG scores for OSA. Probability of maintaining sinus rhythm after RFA was similar among patients with known OSA (66/94, 70%) and high risk OSA scores (95/124, 77%) and higher than among patients with low risk OSA scores (29/32, 91%, P=0.03). Among patients without prior OSA, a high risk STOP-BANG score did predict recurrent AF (OR = 3.7, 95 % CI 1.4–11.4, P = 0.0005). Multivariate analysis showed a higher risk of atrial arrhythmia recurrence for non-paroxysmal AF patients (OR = 3.1, ± 95 % CI 1.4–7.1, P = 0.005).

Conclusions

The majority of AF patients undergoing RFA have high risk OSA scores, suggesting that OSA is vastly underdiagnosed in this population. STOP-BANG independently predicted recurrent AF in patients without a prior diagnosis of OSA.

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Disclosures

This work was supported in part by a MICHR Grant for support of clinical and translational research, UL1RR024986. The authors have no financial or other conflict of interest. The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the paper, and its final contents.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Cardiovascular Center, University of Michigan Health System, Room 2722, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5853, USA

    Peter M. Farrehi, Hatice Duygu Bas, Kazim Baser, Krit Jongnarangsin, Rakesh Latchamsetty, Hamid Ghanbari, Thomas Crawford, Frank Bogun, Eric Good, Frank Pelosi, Aman Chugh, Fred Morady & Hakan Oral

  2. Department of Neurology, University of Michigan Health System, Ann Arbor, MI, USA

    Louise M. O’Brien

  3. Department of Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor, MI, USA

    Louise M. O’Brien

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  1. Peter M. Farrehi
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  2. Louise M. O’Brien
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  3. Hatice Duygu Bas
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  4. Kazim Baser
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  9. Frank Bogun
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  11. Frank Pelosi
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  13. Fred Morady
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  14. Hakan Oral
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Correspondence to Peter M. Farrehi.

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Farrehi, P.M., O’Brien, L.M., Bas, H.D. et al. Occult obstructive sleep apnea and clinical outcomes of radiofrequency catheter ablation in patients with atrial fibrillation. J Interv Card Electrophysiol 43, 279–286 (2015). https://doi.org/10.1007/s10840-015-0014-4

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  • DOI: https://doi.org/10.1007/s10840-015-0014-4

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