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Review
. 2022 Oct;247(20):1827-1832.
doi: 10.1177/15353702221120289. Epub 2022 Sep 12.

Vagal milieu or electrophysiologic substrate? The link between atrial fibrillation and obstructive sleep apnea

Ikechukwu Ifedili  1 , Eva Ingram  2 , Courtland Blount  2 , Sharif Kayali  2 , Mark Heckle  1   3 , Yehoshua C Levine  1   3
Affiliations
Review

Vagal milieu or electrophysiologic substrate? The link between atrial fibrillation and obstructive sleep apnea

Ikechukwu Ifedili et al. Exp Biol Med (Maywood). 2022 Oct.

Abstract

Atrial fibrillation is the most common cardiac arrhythmia with its prevalence expected to increase to 12.1 million people in the United States by 2030. Chronic underlying conditions that affect the heart and lungs predispose patients to develop atrial fibrillation. Obstructive sleep apnea is strongly associated with atrial fibrillation. Several pathophysiological mechanisms have been proposed to elucidate this relationship which includes electrophysiological substrate modification and the contribution of the autonomic nervous system. In this comprehensive review, we highlight important relationships and plausible causality between obstructive sleep apnea and atrial fibrillation which will improve our understanding in the evaluation, management, and prevention of atrial fibrillation. This is the most updated comprehensive review of the relationship between obstructive sleep apnea and atrial fibrillation.

Keywords: Cardiovascular; electrophysiology; heart; hypoxia; medicine; pulmonary.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Pathophysiological mechanisms causing atrial fibrillation in patients with obstructive sleep apnea.
See this image and copyright information in PMC

References

    1. Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, Seward JB, Tsang TSM. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota,1980 to 2000, and implications on the projections for future prevalence. Circulation 2006;114:119–25 - PubMed
    1. Colilla S, Crow A, Petkun W, Singer DE, Simon T, Liu X. Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Am J Cardiol 2013;112:1142–7 - PubMed
    1. Abbasi A, Gupta SS, Sabharwal N, Meghrajani V, Sharma S, Kamholz S, Kupfer Y. A comprehensive review of obstructive sleep apnea. Sleep Sci 2021;14:142–54 - PMC - PubMed
    1. Linz D, Hendriks J. Central sleep apnea in atrial fibrillation: risk factor or marker of untreated underlying disease. Int J Cardiol Heart Vasc 2020;30:100650. - PMC - PubMed
    1. Moula AI, Parrini I, Tetta C, Luca F, Parise G, Rao CM, Mauro E, Parise O, Matteucci F, Gulizia MM, La Meir M, Gelsomino S. Obstructive sleep apnea and atrial fibrillation. J Clin Med 2022;11 - PMC - PubMed