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Atrial fibrillation and sleep apnea

Emmanuelle Berthelot, David Montani, Vincent Algalarrondo, Céline Dreyfus, Raed Rifai, Anouar Benmalek, Xavier Jais, Amir Bouchachi, Laurent Savale, Gerald Simonneau, Denis Chemla, Marc Humbert, Olivier Sitbon, Patrick Assayag
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a frequent cause of pulmonary hypertension (PH) that is not easy to differentiate from precapillary PH. We aimed to determine whether the characteristic features of the patients may help differentiate between HFpEF and precapillary-PH. METHODS AND RESULTS: Clinical and echocardiographic parameters were analyzed in 156 patients referred to our PH referral center. Right heart catheterization identified 78 PH-HFpEF patients and 78 precapillary-PH...
October 11, 2016: Journal of Cardiac Failure
E Sh Bairambekov, A V Pevzner, A Yu Litvin, O A Fomicheva
The case history of a 46-year-old patient with obstructive sleep apnea syndrome was analyzed. The examination revealed fourth-degree obesity, prior myocardial infarction, persistent atrial fibrillation with nocturnal asystoles lasting as long as 14.3 sec. During selected drug therapy and regular application of secondary ventilation (continuous positive airway pressure (CPAP) therapy) used to correct breathing problems, there was a reduction in the signs of circulatory deficiency, cessation of cardiac pauses, and recovery of sinus rhythm...
2016: Terapevticheskiĭ Arkhiv
Anna M May, David R Van Wagoner, Reena Mehra
A surge of data has reproducibly identified strong associations of obstructive sleep apnea (OSA) with cardiac arrhythmias. As an extension of epidemiologic and clinic-based findings, experimental investigations have made strides in advancing our understanding of the putative OSA and cardiac arrhythmogenesis mechanistic underpinnings. While most studies have focused on the links between OSA and atrial fibrillation (AF), relationships with ventricular arrhythmias have also been characterized. Key findings implicate OSA-related autonomic nervous system fluctuations typified by enhanced parasympathetic activation during and sympathetic surges subsequent to respiratory events which contribute to augmented arrhythmic propensity...
September 29, 2016: Chest
Sana Salah, Mariem Rekik, Soumaya Boudokhane, Houda Migaou, Anis Jellad, Zohra Ben Salah Frih
OBJECTIVE: To assess the prevalence of sleep disorders (SD) in ischemic stroke (IS) patients followed in physical medicine and rehabilitation (PMR) and to compare this prevalence to that found in a control population. MATERIAL/PATIENTS AND METHODS: A cross-sectional study was conducted over a period of 8 months. We enrolled IS patients and case controls matched for age and sex and who met the inclusion criteria. The data studied were epidemiological and clinical...
September 2016: Annals of Physical and Rehabilitation Medicine
K I Konovalova, E M Elfimova, E A Butorova, A V Aksenova, P V Galitsin, O S Bulkina, A Yu Litvin, I E Chazova
The paper describes a clinical case of a female patient with severe obstructive sleep apnea syndrome in the presence of congenital hemangioma of the face, soft palate, and tongue concurrent with paroxysmal atrial fibrillation and atrial flutter, paroxysmal supraventricular tachycardia, and sinoatrial block (maximally up to 3.9 sec). Continuous positive airway pressure therapy could reduce the number of paroxysms of atrial fibrillation and atrial flutter, supraventricular tachycardia and eliminate sinoatrial block...
2016: Terapevticheskiĭ Arkhiv
Anna Kazimierczak, Paweł Krzesiński, Grzegorz Gielerak, Beata Uziębło-Życzkowska, Paweł Smurzyński, Robert Ryczek, Andrzej Cwetsch, Andrzej Skrobowski
BACKGROUND Advanced heart failure (HF) is commonly accompanied by central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR). The aim of this study was to evaluate the relationship between CSA/CSR and other clinical features of HF, with particular emphasis on cardiovascular hemodynamics. MATERIAL AND METHODS In 161 stable HF patients with left ventricular ejection fraction (LVEF) ≤45% (NYHA class I-III; mean LVEF 32.8%) the clinical evaluation included: LVEF; left and right ventricular end-diastolic diameter (LVDd, RVDd); ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e') assessed by echocardiography; stroke index (SI); heart rate (HR); cardiac index (CI); and systemic vascular resistance index (SVRI) assessed by impedance cardiography (ICG)...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Yanhui Li, Mathew D Olson, Jian-Ming Li
A 79-year-old man received a dual-chamber pacemaker (Evia DR-T, Biotronik GmbH, Berlin, Germany) for syncope and sick sinus syndrome with paroxysmal atrial fibrillation. His past medical history included systemic hypertension, hyperlipidemia, coronary artery disease, diabetes mellitus type II, obstructive sleep apnea, diffuse lung disease, diastolic congestive heart failure with preserved systolic function. This article is protected by copyright. All rights reserved.
August 24, 2016: Pacing and Clinical Electrophysiology: PACE
Liliana Otero, Patricia Hidalgo, Rafael González, Carlos A Morillo
Otero, Liliana, Patricia Hidalgo, Rafael González, and Carlos A. Morillo. Association of cardiovascular disease and sleep apnea at different altitudes. High Alt Med Biol. 16:000-000, 2016.-We evaluated the prevalence of sleep apnea (SA) in patients with cardiovascular disease (CVD) at different altitudes. A total of 398 subjects with coronary artery disease (CAD), 144 subjects with atrial fibrillation (AF), and 292 controls (without CVD) were recruited in three cities at sea level, moderate altitude, and high altitude...
August 16, 2016: High Altitude Medicine & Biology
Laura B Ponsaing, Helle K Iversen, Poul Jennum
PURPOSE: The purpose of the study was to assess polysomnographic indicators of increased mortality risk in patients with stroke or a transient ischemic attack (TIA). METHODS: We performed polysomnographies in 63 acute stroke/TIA patients. Mortality data were collected from a national database after a 19-37-month follow-up period. RESULTS: Of the 57 stroke and 6 TIA patients, 9 stroke patients died during follow-up. All nine had moderate or severe sleep-related breathing disorders (SRBDs)...
July 30, 2016: Sleep & Breathing, Schlaf & Atmung
Mark S Link, Michel Haïssaguerre, Andrea Natale
Atrial fibrillation (AF) is the most common arrhythmia encountered by cardiologists and is a major cause of morbidity and mortality. Risk factors for AF include age, male sex, genetic predisposition, hypertension, diabetes mellitus, sleep apnea, obesity, excessive alcohol, smoking, hyperthyroidism, pulmonary disease, air pollution, heart failure, and possibly excessive exercise. The management of AF involves decisions about rate versus rhythm control. Asymptomatic patients are generally managed with rate control and anticoagulation...
July 26, 2016: Circulation
Mark I Boulos, Anthony Wan, James Im, Sara Elias, Fadi Frankul, Mina Atalla, Sandra E Black, Vincenzo S Basile, Arun Sundaram, Julia J Hopyan, Karl Boyle, David J Gladstone, Brian J Murray, Richard H Swartz
OBJECTIVE: Despite its high prevalence and unfavorable clinical consequences, obstructive sleep apnea (OSA) often remains underappreciated after cerebrovascular events. The purpose of our study was to evaluate the clinical utility of four simple paper-based screening tools for excluding OSA after stroke or transient ischemic attack (TIA). PATIENTS/METHODS: Sixty-nine inpatients and outpatients with stroke or TIA during the past 180 days completed the 4-Variable screening tool (4V), STOP-BAG questionnaire (ie, STOP-BANG questionnaire without the neck circumference measurement), Berlin questionnaire, and the Sleep Obstructive apnea score optimized for Stroke (SOS)...
May 2016: Sleep Medicine
Ning Ding, Bu-Qing Ni, Hong Wang, Wen-Xiao Ding, Rong Xue, Wei Lin, Zhang Kai, Shi-Jiang Zhang, Xi-Long Zhang
STUDY OBJECTIVES: Sleep apnea is common in patients referred for cardiac valve replacement (CVR). We aimed to determine the association of obstructive sleep apnea (OSA) and central sleep apnea (CSA) with perioperative events in CVR surgery in patients with rheumatic valvular heart disease (RVHD). METHODS: Between April 2010 and April 2014, 290 patients with RVHD undergoing CVR were screened for sleep apnea 1 to 7 days before CVR. Baseline medications, cardiac function, sleep parameters, perioperative events, and related risk factors were evaluated...
July 19, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Jonathan P Piccini, DaJuanicia N Simon, Benjamin A Steinberg, Laine Thomas, Larry A Allen, Gregg C Fonarow, Bernard Gersh, Elaine Hylek, Peter R Kowey, James A Reiffel, Gerald V Naccarelli, Paul S Chan, John A Spertus, Eric D Peterson
IMPORTANCE: Despite the frequency of atrial fibrillation (AF) in clinical practice, relatively little is known about sex differences in symptoms and quality of life and how they may affect treatment and outcomes. OBJECTIVE: To determine whether symptoms, quality of life, treatment, and outcomes differ between women and men with AF. DESIGN, SETTING, AND PARTICIPANTS: This observational cohort study included 10 135 patients with AF. The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation is a prospective, nationwide, multicenter outpatient registry of patients with incident and prevalent AF enrolled at 176 sites between June 2010 and August 2011...
June 1, 2016: JAMA Cardiology
Agnieszka Kapłon-Cieślicka, Agata Tymińska, Michał Peller, Paweł Balsam, Krzysztof Ozierański, Michalina Galas, Michał Marchel, Maria G Crespo-Leiro, Aldo Pietro Maggioni, Jarosław Drożdż, Krzysztof J Filipiak, Grzegorz Opolski
Compared with heart failure (HF) with reduced ejection fraction (HF-REF), the diagnosis of HF with preserved EF (HF-PEF) is more challenging. The aim of the study was to assess the prevalence of HF-PEF among patients hospitalized for HF, to evaluate the pertinence of HF-PEF diagnosis and to compare HF-PEF and HF-REF patients with respect to outcomes. The analysis included 661 Polish patients hospitalized for HF, selected from the European Society of Cardiology (ESC)-HF Long-Term Registry. Patients with an EF of ≥50% were included in the HF-PEF group and patients with an EF of <50% - in the HF-REF group...
August 15, 2016: American Journal of Cardiology
Hiroshi Kawakami, Takayuki Nagai, Akira Fujii, Teruyoshi Uetani, Kazuhisa Nishimura, Katsuji Inoue, Jun Suzuki, Yasunori Oka, Takafumi Okura, Jitsuo Higaki, Akiyoshi Ogimoto, Shuntaro Ikeda
PURPOSE: The relationship between atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) and sleep-disordered breathing (SDB) evaluated using type-3 portable monitoring (PM) is still unknown. We investigated high-risk patients with AF recurrence after initial PVI using the apnea-hypopnea index (AHI) measured by type-3 PM. METHODS: One hundred twenty-four (85 males; age 62 ± 10 years) AF patients undergoing initial PVI were enrolled: 83, paroxysmal AF; 41, persistent AF...
June 8, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Dominik Linz, Mathias Hohl, Shayan Khoshkish, Felix Mahfoud, Christian Ukena, Hans-Ruprecht Neuberger, Klaus Wirth, Michael Böhm
BACKGROUND: Obstructive sleep apnea (OSA) increases susceptibility to atrial fibrillation (AF) by a combined sympatho-vagal hyperactivation. The purpose of this study was to investigate the effect of autonomic nervous system modulation by low-level baroreceptor stimulation (LL-BRS) compared to high-level BRS (HL-BRS) on atrial arrhythmogenic changes in a pig model of OSA. METHODS AND RESULTS: Sixteen pigs received tracheotomy under general urethane/chloralose anesthesia...
September 2016: Journal of Cardiovascular Electrophysiology
Harneet K Walia, Mina K Chung, Sally Ibrahim, Reena Mehra
Accumulating data implicate obstructive sleep apnea (OSA) as a predisposing factor to the development of atrial fibrillation (AF), the latter representing the most common sustained cardiac arrhythmia. The postulated mechanisms leading to atrial arrhythmogenesis in OSA include alterations in intrathoracic pressures, intermittent hypoxemia, and autonomic nervous system fluctuations. Although these OSA-related pathophysiologic pathways may result in atrial structural and electrical remodeling, thereby predisposing to AF, there are data to suggest that the immediate influences of respiratory events may trigger arrhythmic events...
2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Gal Ifergane, Andrey Ovanyan, Ronen Toledano, Aviv Goldbart, Ibrahim Abu-Salame, Asher Tal, Moshe Stavsky, Victor Novack
BACKGROUND AND PURPOSE: Sleep-disordered breathing is common among patients with stroke resulting in 4- to 6-fold higher prevalence of obstructive sleep apnea (OSA). We prospectively evaluated clinical characteristics and laboratory markers of inflammation and coagulability associated with OSA severity during the acute post stroke period. METHODS: Consecutive patients admitted to the department of Neurology after an acute ischemic stroke were evaluated during the first 48 hours of symptom onset using Watch peripheral arterial tonometry, a wrist-worn ambulatory sleep study device that utilizes peripheral arterial tonometry...
May 2016: Stroke; a Journal of Cerebral Circulation
Thomas Gaisl, Annette M Wons, Valentina Rossi, Daniel J Bratton, Christian Schlatzer, Esther I Schwarz, Giovanni Camen, Malcolm Kohler
BACKGROUND: A high P-wave duration and dispersion (Pd) have been reported to be a prognostic factor for the occurrence of paroxysmal atrial fibrillation (PAF), a condition linked to obstructive sleep apnea (OSA). We tested the hypothesis of whether a short-term increase of P-wave duration and Pd can be induced by respiratory manoeuvres simulating OSA in healthy subjects and in patients with PAF. METHODS: 12-lead-electrocardiography (ECG) was recorded continuously in 24 healthy subjects and 33 patients with PAF, while simulating obstructive apnea (Mueller manoeuvre, MM), obstructive hypopnea (inspiration through a threshold load, ITH), central apnea (AP), and during normal breathing (BL) in randomized order...
2016: PloS One
Chrishan J Nalliah, Prashanthan Sanders, Jonathan M Kalman
Prevalence rates of atrial fibrillation (AF) and obstructive sleep apnea (OSA) are rising on a global scale. Epidemiological data have consistently demonstrated an independent association between the 2 conditions. Investigators pose that pathophysiologic features of OSA enable progression of the AF substrate; these features include abnormalities of gas exchange, autonomic remodeling, atrial stretch, and inflammation. Furthermore, many of the mechanistic perturbations that impact the AF substrate in OSA can be substantially attenuated by effective treatment with continuous positive airway pressure (CPAP)...
August 2016: Journal of Cardiovascular Electrophysiology
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