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CPAP use reduces AF recurrence in patients with obstructive sleep apnea
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Use of continuous positive airway pressure was associated with significant reduction in the recurrence of atrial fibrillation in patients with obstructive sleep apnea, according to a meta-analysis published in the Journal of the American College of Cardiology: Clinical Electrophysiology.
Researchers performed the meta-analysis of studies evaluating the effect of treatment with continuous positive airway pressure (CPAP) on recurrence of AF in patients with obstructive sleep apnea, which is a known predictor for onset and recurrence of AF.
“Our study confirms the expanding body of evidence that treatment of modifiable risk factors has a significant impact on the long-term suppression of [AF] regardless of the type of therapy offered,” Larry A. Chinitz, MD, professor of medicine and cardiac electrophysiology at the New York University School of Medicine, said in a press release.
The researchers analyzed seven prospective cohort studies covering 1,087 patients. Across all patient groups, CPAP use was associated with a significant reduction in AF recurrence (RR = 0.58; 95% CI, 0.51-0.67; heterogeneity chi-square P = .91; I2 = 0%).
The benefit was consistent regardless of whether a patient underwent catheter ablation with pulmonary vein isolation (RR = 0.58; 95% CI, 0.5-0.67; heterogeneity chi-square P = .72; I2 = 0%) or received medical management (RR = 0.58; 95% CI, 0.36-0.96; heterogeneity chi-square P = .6; I2 = 0%), according to the researchers.
No other covariates showed any significant association with AF recurrence, including study duration, age, sex, BMI, hypertension, diabetes, CAD, left atrial dimension, antiarrhythmic drug use, percent of patients with nonparoxysmal AF and left ventricular ejection fraction.
“Active screening for obstructive sleep apnea in all patients who undergo treatment for [AF] is imperative as use of CPAP will influence the outcome of therapy and likely reduce some of the [CV] morbidity associated with [AF],” Chinitz said in the release. “Technology for home screening of sleep apnea needs to be made widely available and become as routine as measurements of [BP] and blood sugar levels in diabetics.” – by Erik Swain
Disclosure: Chinitz reports receiving fellowship grants from Biotronik, Boston Scientific and Medtronic and consulting for St. Jude Medical.
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