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Updated: Aug 6, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Bidirectional temporal association of device-detected atrial fibrillation and sleep apnea
Philipp Spitaler1, Valentin Bilgeri1, Gudrun Feuchtner2
1Department of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria.
Heart Rhythm
|July 18, 2026
Summary
Device-detected atrial fibrillation (AF) and sleep apnea (SA) show a bidirectional relationship. Elevated AF burden precedes sleep apnea, while sleep apnea increases the risk of new and ongoing AF episodes.
Area of Science:
- Cardiology
- Sleep Medicine
- Medical Device Technology
Background:
- The association between atrial fibrillation (AF) and sleep apnea (SA) is known, but the precise day-to-day temporal sequence is unclear.
- Continuous remote monitoring offers a novel approach to investigate this relationship.
Purpose of the Study:
- To investigate the bidirectional day-to-day association between device-detected AF (DDAF) and device-detected SA (DDSA).
- To differentiate between the onset of new DDAF episodes and the continuation of existing ones in relation to DDSA.
Main Methods:
- Prospective ACaSA study utilizing data from pacemaker patients with continuous remote monitoring (September 2020 - August 2025).
- Case-crossover analyses examined preceding day/night associations between DDAF burden and severe DDSA (Respiratory Disturbance Index ≥ 20).
- Generalized linear mixed-effects models were employed for secondary analyses.
Main Results:
- Analysis included 112,242 patient-days from 218 patients.
- Higher DDAF burden on the prior day was associated with increased odds of incident severe DDSA in a graded manner.
- Severe DDSA on the prior night was linked to higher odds of both new DDAF episode onset and continuation of ongoing DDAF episodes.
Conclusions:
- Continuous monitoring reveals a bidirectional temporal link between DDAF and DDSA.
- Elevated DDAF burden precedes severe DDSA, while severe DDSA precedes both the onset and continuation of DDAF episodes.
