Dados do Trabalho

Título

The impact of Obstructive Sleep Apnea on the day-night pattern of Paroxysmal Atrial Fibrillation

Introdução

Atrial Fibrillation (AF) is the most prevalent cardiac arrhythmia, with significant morbidity and mortality. Recent evidence indicates that Obstructive Sleep Apnea (OSA) is associated with a higher occurrence and recurrence of AF. However, it is not clear the prevalence of OSA and the potential relevance of this sleep disorder in modulating the day - night pattern of occurrence of one of the relevant forms of AF, the so-called Paroxysmal AF (PAF), within 24 hours. Thus, the aim of this study is to assess the prevalence of OSA in patients with FAP and to compare the period of occurrence of FAP in patients with and without OSA. Our hypothesis is that patients with OSA would have a higher frequency of at least one episode of FAP during sleep than patients without OSA.

Objetivo

The aim of this study is to assess the prevalence of OSA in patients with FAP and to compare the period of occurrence of FAP in patients with and without OSA. Our hypothesis is that patients with OSA would have a higher frequency of at least one episode of FAP during sleep than patients without OSA.

Métodos

We recruited consecutive patients who underwent 24-hour electrocardiographic monitoring (Holter) and showed at least one episode of PAF within 24 hours. Regardless of sleep-related signs and symptoms and Holter data, all FAP patients were asked to undergo a clinical assessment that included demographic data and anthropometric measurements. For objective sleep assessment, we performed portable monitoring using the validated Watch-PATTM device. OSA was defined as an apnea-hypopnea index ≥15 events per hour.

Resultados

We studied 101 patients (mean age: 62.6±10 years, 57.4% men, body mass index: 29±5 kg/m2). The frequency of OSA was 55.4% (56 patients). None of them had a previous diagnosis of OSA and therefore did not undergo specific treatment. Regarding the time of occurrence of PAF episodes, divided into wakefulness, sleep and both periods, we did not observe differences between the groups with and without OSA: wakefulness: 19 vs 50%, sleep: 11 vs 6; both periods: 26 vs 16%, respectively (all p>0.05 values). We also did not observe differences in the number of FAP episodes and in the duration of these episodes in the comparison between the two groups.

Conclusões

This analysis suggests that OSA is common in patients with FAP but is not associated with an increased occurrence of overnight FAP episodes.

Palavras -chave

obstructive sleep apnea and paroxysmal atrial fibrillation