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Cardiac rhythm disorders in obstructive sleep apnea.
Glaucylara Reis Geovanini1,2, Geraldo Lorenzi-Filho1
1Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Journal of Thoracic Disease
|January 29, 2019
Summary
Obstructive sleep apnea (OSA) is linked to cardiac arrhythmias through various mechanisms. Treating OSA with CPAP may reduce atrial fibrillation recurrence, but more clinical trials are needed to confirm the association.
Area of Science:
- Cardiology
- Sleep Medicine
- Internal Medicine
Background:
- Obstructive sleep apnea (OSA) is prevalent in patients with cardiac rhythm disorders.
- OSA can trigger arrhythmias via negative intrathoracic pressure, hypoxia, and sympathetic surges.
- OSA-induced atrial remodeling is a substrate for atrial fibrillation (AF).
Purpose of the Study:
- To review the scientific evidence linking OSA to cardiac rhythm disorders.
- To explore biological pathways connecting OSA and arrhythmogenesis.
- To identify future research directions.
Main Methods:
- Review of current scientific literature and observational studies.
- Analysis of biological mechanisms linking OSA and cardiac arrhythmias.
- Examination of evidence from studies on CPAP treatment and arrhythmia recurrence.
Main Results:
- OSA is associated with increased susceptibility to various arrhythmias, including AF.
- Nocturnal hypoxemia in OSA predicts sudden cardiac death and increases risk in ICD patients.
- CPAP treatment for OSA shows potential in reducing AF recurrence post-ablation or cardioversion.
Conclusions:
- Multiple biological pathways link OSA to cardiac arrhythmogenesis.
- Observational data suggest an association, but large clinical trials are needed to clarify causality.
- Further research is required to establish the independent role of OSA in cardiac rhythm disorders.
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