Highlights
- •Obstructive sleep apnea (OSA) is a significant risk factor for atrial fibrillation (AF).
- •Several mechanisms have been implicated in AF occurrence in OSA patients.
- •Treatment of OSA is an important component of AF management.
Abstract
Atrial fibrillation (AF) is the commonest arrhythmia in clinical practice and is associated
with increased cardiovascular morbidity and mortality. Obstructive sleep apnea (OSA),
a common breathing disorder, is an independent risk factor for AF. Several pathophysiological
mechanisms, including apnea-induced hypoxia, intrathoracic pressure shifts, sympathovagal
imbalance, atrial remodeling, oxidative stress, inflammation and neurohumoral activation
have been implicated in the occurrence of AF in OSA patients. In addition, OSA has
been shown to reduce success rates of antiarrhythmic drugs, electrical cardioversion
and catheter ablation in AF. Effective prevention of obstructive respiratory events
by continuous positive airway pressure ventilation (CPAP) reduces sympathovagal activation
and recurrence of AF. The present review describes the relationship between OSA and
AF, presents the pathophysiological mechanisms implicating OSA in AF occurrence, and
provides an update of the potential therapeutic interventions for patients with OSA
and AF.
Keywords
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Article info
Publication history
Published online: December 22, 2016
Accepted:
December 17,
2016
Received in revised form:
December 12,
2016
Received:
August 22,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
