Sleep-disordered breathing predicts sinus node dysfunction in persistent atrial fibrillation patients undergoing...

Area of Science:

• Cardiology
• Electrophysiology
• Sleep Medicine

Background:

• Catheter ablation for persistent atrial fibrillation (AF) aims to maintain sinus rhythm.
• Sick sinus syndrome (SND) may become apparent after AF ablation, sometimes necessitating pacemakers.
• Predicting pre-existing SND before ablation is crucial for patient management.

Purpose of the Study:

• To investigate if underlying sinus node dysfunction (SND) in patients with persistent AF can be predicted before catheter ablation.
• To identify predictors of SND in patients undergoing ablation for persistent AF.

Main Methods:

• 87 patients with persistent AF undergoing catheter ablation were studied.
• Nocturnal polysomnography and echocardiography were performed pre-ablation.
• SND was defined by corrected sinus node recovery time (≥550ms) post-ablation; sleep-disordered breathing assessed by apnea/hypopnea index (AHI).

Main Results:

• 48% of patients (42/87) exhibited SND post-ablation.
• The SND group had a significantly higher AHI than the normal sinus node function group (25.7±13 vs. 17.5±11).
• Moderate to severe sleep-disordered breathing (AHI≥15) independently predicted SND after AF ablation.

Conclusions:

• Underlying sinus node dysfunction in persistent AF patients can be predicted by assessing sleep-disordered breathing prior to catheter ablation.
• Evaluating sleep-disordered breathing may help guide ablation decisions and anticipate potential pacemaker needs.