scholarly journals Atrial fibrillation and sleep apnoea - a review of the mechanical interplay

2021 ◽  
Vol 5 (3) ◽  
pp. 36
Author(s):  
Vaibhav Mishra
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Apnoea

scholarly journals P095 Heart Rate Variability during Sleep in Paroxysmal Atrial Fibrillation patients with and without Obstructive Sleep Apnoea

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A52-A52
Author(s):  
A Mohammadieh ◽  
H Dissanayake ◽  
K Sutherland ◽  
S Ucak ◽  
P de Chazal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Obstructive Sleep Apnoea ◽  
Paroxysmal Atrial Fibrillation ◽  
Sleep Apnoea ◽  
Relative Reduction ◽  
Obstructive Sleep ◽  
Sympathetic Modulation ◽  
Ectopic Beats

Abstract Introduction Physiological studies have demonstrated the importance of the autonomic nervous system in mediating acute apnoea-induced atrial fibrillation (AF). We aimed to compare Heart Rate Variability (HRV) markers of autonomic function in paroxysmal atrial fibrillation (PAF) patients with and without obstructive sleep apnoea (OSA). A secondary aim was the analysis of ectopic beats in these groups. Methods Nocturnal ECG traces from 89 PAF patients who underwent in-laboratory polysomnography were included. After identifying ectopic beats in the ECGs, periods of arrhythmia as well as sleep apnoea events were excluded. HRV time and frequency domains were reported by sleep stage (REM vs Non-REM) for patients with and without OSA. Results Frequency domain analysis of HRV during non-REM sleep in PAF patients with OSA showed increased cardiac parasympathetic modulation (HF-nu: 39.13 ± 15.74 vs 47.98 ± 14.60, p = 0.008*) and reduced cardiac sympathetic modulation (LF/HF ratio: 2.05 ± 2.02 vs 1.17 ± 0.98, p = 0.007*). Results remained significant after adjusting for age, sex and BMI (adjusted p values 0.024 and 0.018 respectively). PAF patients with severe OSA (AHI ≥ 30/hr) had more AF beats and Ventricular Ectopic Beats than those without severe OSA (22.7 ± 42.8% vs 3.7 ± 17.9%, p = 0.006*, 1.7 ± 3.8 vs 0.3 ± 0.9%, p = 0.004* respectively). Conclusions This is the first study of HRV in AF patients with and without OSA. It suggests a chronic increase in parasympathetic nervous modulation and relative reduction in sympathetic modulation in PAF patients with OSA.

Atrial fibrillation and sleep apnoea and chronic obstructive pulmonary disease

ESC CardioMed ◽  
2018 ◽  
pp. 2235-2237
Author(s):  
Tauseef Akhtar ◽  
Jared D. Miller ◽  
Hugh Calkins
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Risk Factor Modification ◽  
Obstructive Sleep ◽  
P Rate

Rate control, rhythm control, and anticoagulation are well entrenched as the three central pillars of atrial fibrillation (AF) management. Risk factor modification of other associated co-morbidities is now emerging as a critical fourth pillar in the prevention and management of AF. Obstructive sleep apnoea and chronic obstructive pulmonary disease, in particular, have important implications in the development of AF and appropriate selection of therapy. This chapter reviews the pathophysiology and clinical evidence linking these conditions with AF. In addition, it discusses important considerations in the management of concurrent AF and obstructive sleep apnoea or chronic obstructive pulmonary disease.

Atrial fibrillation and sleep apnoea and chronic obstructive pulmonary disease

ESC CardioMed ◽  
2018 ◽  
pp. 2235-2237
Author(s):  
Jared D. Miller ◽  
Hugh G. Calkins
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Risk Factor Modification ◽  
Obstructive Sleep ◽  
P Rate

Rate control, rhythm control, and anticoagulation are well entrenched as the three central pillars of atrial fibrillation (AF) management. Risk factor modification of other associated co-morbidities is now emerging as a critical fourth pillar in the prevention and management of AF. Obstructive sleep apnoea and chronic obstructive pulmonary disease, in particular, have important implications in the development of AF and appropriate selection of therapy. This chapter reviews the pathophysiology and clinical evidence linking these conditions with AF. In addition, it discusses important considerations in the management of concurrent AF and obstructive sleep apnoea or chronic obstructive pulmonary disease.

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