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Review
. 2021 Mar;13(1):87-94.
doi: 10.1016/j.ccep.2020.10.003.

Sleep Apnea and Atrial Fibrillation

Dominik Linz  1 , Stanley Nattel  2 , Jonathan M Kalman  3 , Prashanthan Sanders  4
Affiliations
Review

Sleep Apnea and Atrial Fibrillation

Dominik Linz et al. Card Electrophysiol Clin. 2021 Mar.

Abstract

Obstructive sleep apnea (OSA) creates a complex and dynamic substrate for atrial fibrillation (AF), which is characterized by structural remodeling as a result of long-term OSA as well as transient and acute apnea-associated transient atrial electrophysiological changes. OSA is present in 21% to 74% of patients with AF, and nonrandomized studies suggest that treatment of OSA by continuous positive airway pressure may help to maintain sinus rhythm after electrical cardioversion and improve catheter ablation success rates. Management of OSA in patients with AF requires a close interdisciplinary collaboration between the electrophysiologist/cardiologist and sleep specialists.

Keywords: Atrial fibrillation; Continuous positive air pressure (CPAP); Polygraphy; Pulmonary vein isolation; Screening; Sleep apnea.

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Conflict of interest statement

Disclosure Dr D. Linz is supported by a Beacon Research Fellowship by the University of Adelaide. Drs J.M. Kalman and P. Sanders are supported by Practitioner Fellowships from the National Health and Medical Research Council of Australia. Dr P. Sanders is supported by the National Heart Foundation of Australia. Dr D. Linz reports having served on the advisory board of LivaNova, Respicardia, and Medtronic. Dr D. Linz reports having received lecture and/or consulting fees from LivaNova, Biosense-Webster, Medtronic, Pfizer, Bayer, and ResMed. Dr D. Linz reports having received research funding from Sanofi, ResMed, and Medtronic. Dr P. Sanders reports having served on the advisory board of Biosense-Webster, Medtronic, St Jude Medical, Boston Scientific, and CathRx. Dr P. Sanders reports having received lecture and/or consulting fees from Biosense-Webster, Medtronic, St Jude Medical, and Boston Scientific. Dr P. Sanders reports having received research funding from Medtronic, St Jude Medical, Boston Scientific, Biotronik, and Sorin. The other authors have nothing to disclose.

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