TY - JOUR
T1 - The impact of continuous positive airway pressure treatment on the recurrence of atrial fibrillation post cardioversion
T2 - A randomized controlled trial
AU - Caples, Sean M.
AU - Mansukhani, Meghna P.
AU - Friedman, Paul A.
AU - Somers, Virend K.
N1 - Publisher Copyright:
© 2018
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background: Observational data suggest that positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) can reduce the risk of recurrent atrial fibrillation (AF) post-direct current cardioversion (DCCV) or catheter ablation. Methods: We conducted a study of adult patients with AF and sleep apnea, stratified by age and gender, who underwent successful DCCV to sinus rhythm, and who were randomized to receive PAP or usual care. Those with sleepiness, significant cardiac or respiratory disease were excluded. Patients were followed for ≤1 year. Primary outcome assessed was time to AF recurrence. Secondary outcomes included sleepiness and quality of life measured using the Epworth Sleepiness Scale (ESS) and Functional Outcome of Sleep Questionnaire (FOSQ) respectively. Results: Of 1757 patients that were screened, 34 underwent polysomnography for this study, 25 of whom had an apnea-hypopnea index (AHI) >5/h. Twelve were randomized to PAP therapy and 13 to usual care. All eligible patients were found to have OSA. There were no differences in body mass index, blood pressure, ejection fraction, AHI, or nocturnal oxygen parameters between intervention and control groups (all p > 0.05). AF recurred in 25% of patients in the PAP and control groups, at 129.0 ± 166.5 versus 109.3 ± 73.2 days respectively, p = 0.98; there were no differences in ESS (5.8 ± 2.6 versus 5.7 ± 2.3; p = 0.17) or FOSQ (18.3 ± 1.5 versus 17.5 ± 1.9; p = 0.26) at follow-up. Conclusions: This is the first randomized controlled trial assessing the impact of treatment of OSA on recurrence of AF post-DCCV, and did not detect a difference between those treated with PAP versus usual care. Clinical trial registration: Clinicaltrials.gov, identifier number: NCT00263757.
AB - Background: Observational data suggest that positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) can reduce the risk of recurrent atrial fibrillation (AF) post-direct current cardioversion (DCCV) or catheter ablation. Methods: We conducted a study of adult patients with AF and sleep apnea, stratified by age and gender, who underwent successful DCCV to sinus rhythm, and who were randomized to receive PAP or usual care. Those with sleepiness, significant cardiac or respiratory disease were excluded. Patients were followed for ≤1 year. Primary outcome assessed was time to AF recurrence. Secondary outcomes included sleepiness and quality of life measured using the Epworth Sleepiness Scale (ESS) and Functional Outcome of Sleep Questionnaire (FOSQ) respectively. Results: Of 1757 patients that were screened, 34 underwent polysomnography for this study, 25 of whom had an apnea-hypopnea index (AHI) >5/h. Twelve were randomized to PAP therapy and 13 to usual care. All eligible patients were found to have OSA. There were no differences in body mass index, blood pressure, ejection fraction, AHI, or nocturnal oxygen parameters between intervention and control groups (all p > 0.05). AF recurred in 25% of patients in the PAP and control groups, at 129.0 ± 166.5 versus 109.3 ± 73.2 days respectively, p = 0.98; there were no differences in ESS (5.8 ± 2.6 versus 5.7 ± 2.3; p = 0.17) or FOSQ (18.3 ± 1.5 versus 17.5 ± 1.9; p = 0.26) at follow-up. Conclusions: This is the first randomized controlled trial assessing the impact of treatment of OSA on recurrence of AF post-DCCV, and did not detect a difference between those treated with PAP versus usual care. Clinical trial registration: Clinicaltrials.gov, identifier number: NCT00263757.
KW - Arrhythmia
KW - CPAP
KW - DC cardioversion
KW - Obstructive sleep apnea
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U2 - 10.1016/j.ijcard.2018.11.100
DO - 10.1016/j.ijcard.2018.11.100
M3 - Article
C2 - 30522886
AN - SCOPUS:85057865050
SN - 0167-5273
VL - 278
SP - 133
EP - 136
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -