TY - JOUR

T1 - Sleep apnea and atrial fibrillation

T2 - challenges in clinical and translational research

AU - Linz, Benedikt

AU - Norup Hertel, Julie

AU - Hendriks, Jeroen

AU - Saljic, Arnela

AU - Dobrev, Dobromir

AU - Baumert, Mathias

AU - Jespersen, Thomas

AU - Linz, Dominik

N1 - Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2022

Y1 - 2022

N2 - Introduction: Sleep-disordered breathing (SDB) is present in 21–74% of all patients with atrial fibrillation (AF). Treatment of SDB by positive airway pressure may help to prevent recurrence of AF after electrical cardioversion and help to improve AF ablation success rates in non-randomized studies. Areas covered: In this review, the current understanding of the atrial arrhythmogenic pathophysiology of SDB is summarized, and diagnostic and therapeutic challenges in AF patients are discussed. Current international recommendations are presented, and a comprehensive literature search is undertaken. Expert opinion: AF patients with SDB rarely report SDB-related symptoms such as daytime sleepiness. Therefore, systematic home sleep testing evaluation should be considered for all patients eligible for rhythm control strategy. A close interdisciplinary collaboration between the electrophysiologist/cardiologist, nurses and sleep-specialists are required for the management of SDB in AF patients. An arrhythmia-orientated assessment of SDB may better quantify SDB-related AF risk in an individual patient and may help to better guide targeted and personalized SDB treatment in AF patients as a component of rhythm and symptom control strategies. Finally, randomized controlled trials are needed to confirm the relationship between SDB and AF, and the benefits of routine testing and treatment of SDB in AF patients.

AB - Introduction: Sleep-disordered breathing (SDB) is present in 21–74% of all patients with atrial fibrillation (AF). Treatment of SDB by positive airway pressure may help to prevent recurrence of AF after electrical cardioversion and help to improve AF ablation success rates in non-randomized studies. Areas covered: In this review, the current understanding of the atrial arrhythmogenic pathophysiology of SDB is summarized, and diagnostic and therapeutic challenges in AF patients are discussed. Current international recommendations are presented, and a comprehensive literature search is undertaken. Expert opinion: AF patients with SDB rarely report SDB-related symptoms such as daytime sleepiness. Therefore, systematic home sleep testing evaluation should be considered for all patients eligible for rhythm control strategy. A close interdisciplinary collaboration between the electrophysiologist/cardiologist, nurses and sleep-specialists are required for the management of SDB in AF patients. An arrhythmia-orientated assessment of SDB may better quantify SDB-related AF risk in an individual patient and may help to better guide targeted and personalized SDB treatment in AF patients as a component of rhythm and symptom control strategies. Finally, randomized controlled trials are needed to confirm the relationship between SDB and AF, and the benefits of routine testing and treatment of SDB in AF patients.

KW - Atrial fibrillation

KW - CPAP

KW - polygraphy

KW - pulmonary vein isolation

KW - screening

KW - sleep apnea

UR - http://www.scopus.com/inward/record.url?scp=85125245799&partnerID=8YFLogxK

U2 - 10.1080/14779072.2022.2036606

DO - 10.1080/14779072.2022.2036606

M3 - Journal article

C2 - 35094618

AN - SCOPUS:85125245799

VL - 20

SP - 101

EP - 109

JO - Expert Review of Cardiovascular Therapy

JF - Expert Review of Cardiovascular Therapy

SN - 1477-9072

IS - 2

ER -