Atrial fibrillation, sleep apnea and obesity

Mina K. Chung, Nancy Foldvary-Schaefer, Virend K. Somers, Paul A. Friedman, Paul J. Wang

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Background: A 60-year-old male with obesity (body-mass index 43 kg/m 2) presented with recurrent symptomatic atrial fibrillation (AF), which he had had since age 41 years. The AF was refractory to treatment with antiarrhythmic drugs. Pacemaker implantation for tachycardia-bradycardia syndrome was required as well as ablation for atrial flutter, and the patient underwent a total of four DC cardioversions. Sleep studies showed mild to moderate obstructive sleep apnea, but continuous positive airway pressure was not tolerated. Pacemaker interrogations demonstrated mode-switch episodes, indicating continuing AF. He was scheduled for catheter ablation targeting pulmonary vein antral isolation. He embarked on a weight-loss program, which successfully reduced AF burden. Investigations: Echocardiography, stress testing, polysomnography, pacemaker interrogations and C-reactive protein. Diagnosis: AF, atrial flutter, tachycardia-bradycardia syndrome, obstructive sleep apnea and morbid obesity. Management: Antiarrhythmic drug therapy, DC cardioversion, anticoagulation, atrial flutter ablation, permanent pacemaker implantation, continuous positive airway pressure and weight loss.

Original languageEnglish (US)
Pages (from-to)56-59
Number of pages4
JournalNature Clinical Practice Cardiovascular Medicine
Volume1
Issue number1
DOIs
StatePublished - Nov 1 2004

Keywords

  • Arrhythmia
  • Atrial fibrillation
  • Morbid obesity
  • Obstructive sleep apnea
  • Weight loss

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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