Incident Arrhythmias Detected Using Implantable Loop Recorders in Obstructive Sleep Apnoea

Area of Science:

• Cardiology
• Sleep Medicine
• Epidemiology

Background:

• Obstructive sleep apnoea (OSA) is prevalent and associated with increased cardiovascular disease and arrhythmia risk.
• Continuous positive airway pressure (CPAP) is the standard OSA treatment, but its impact on specific arrhythmias remains unclear.
• Arrhythmias are likely underdiagnosed in OSA patients, necessitating advanced detection methods like implantable loop recorders (ILRs).

Purpose of the Study:

• To systematically review observational studies using ILRs to determine arrhythmia incidence in treated OSA patients.
• To evaluate the effectiveness of CPAP in managing arrhythmias within the OSA population.

Main Methods:

• Systematic literature search of Medline/EMBASE databases for observational studies.
• Inclusion of OSA patients without prior arrhythmia history who underwent ILR insertion.
• Quality and bias assessment of included studies using the Observational Study Quality Evaluation (OSQE) tool.

Main Results:

• Three studies with 77 participants were included; outcomes were not comparable for pooling.
• CPAP significantly reduced bradyarrhythmia/pauses, but high incidence of atrial fibrillation (AF) up to 31% was observed.
• AF and tachyarrhythmias appear underdiagnosed in OSA; CPAP may be insufficient for their prevention.

Conclusions:

• Further research is needed to establish the true incidence of arrhythmias in OSA patients.
• Routine arrhythmia screening in OSA patients is recommended.
• Findings may inform updated arrhythmia screening guidelines and identify therapeutic targets for OSA.