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Atrial fibrillation and sleep apnea

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https://www.readbyqxmd.com/read/29429026/modulation-of-renal-sympathetic-innervation-recent-insights-beyond-blood-pressure-control
#1
REVIEW
Dominik Linz, Mathias Hohl, Adrian D Elliott, Dennis H Lau, Felix Mahfoud, Murray D Esler, Prashanthan Sanders, Michael Böhm
Renal afferent and efferent sympathetic nerves are involved in the regulation of blood pressure and have a pathophysiological role in hypertension. Additionally, several conditions that frequently coexist with hypertension, such as heart failure, obstructive sleep apnea, atrial fibrillation, renal dysfunction, and metabolic syndrome, demonstrate enhanced sympathetic activity. Renal denervation (RDN) is an approach to reduce renal and whole body sympathetic activation. Experimental models indicate that RDN has the potential to lower blood pressure and prevent cardio-renal remodeling in chronic diseases associated with enhanced sympathetic activation...
February 10, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29424572/atrial-arrhythmias-and-autonomic-dysfunction-in-rats-exposed-to-chronic-intermittent-hypoxia
#2
Sara L Bober, John Ciriello, Douglas L Jones
Obstructive sleep apnea (OSA), which involves chronic, intermittent hypoxia (CIH), is a major risk factor for developing atrial fibrillation (AF). Whether or not CIH alone alters cardiac mechanisms to support AF is unknown. This study investigated the effects of CIH on atrial electrophysiology and arrhythmia vulnerability, and evaluated the role of autonomics in CIH promotion of AF. Adult male Sprague-Dawley rats were exposed to 8h/day of CIH or normoxia for 7 days. Following exposure, rats were anesthetized for intracardiac electrophysiological studies...
February 9, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29411336/central-sleep-apnea-with-cheyne-stokes-breathing-in-heart-failure-from-research-to-clinical-practice-and-beyond
#3
K Terziyski, A Draganova
Characterized by periodic crescendo-decrescendo pattern of breathing alternating with central apneas, Central sleep apnea (CSA) with Cheyne-Stokes Breathing represents a highly prevalent, yet underdiagnosed comorbidity in chronic heart failure (CHF). A diverse body of evidence demonstrates increased morbidity and mortality in the presence of CSB. CSB has been described in both CHF patients with preserved and reduced ejection fraction, regardless of drug treatment. Risk factors for CSB are older age, male gender, high BMI, atrial fibrillation and hypocapnia...
February 7, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29410745/prevalence-and-predictors-of-arrhythmia-in-patients-with-obstructive-sleep-apnea
#4
Aljohara Saud Almeneessier, Nader Alasousi, Munir M Sharif, Seithikurippu R Pandi-Perumal, Ahmad Salah Hersi, Ahmed Salem BaHammam
Objectives: To assess the prevalence and types of arrhythmias in Saudi OSA patients and to identify predictors of arrhythmia in this group of patients. Methods: This case-control study included all patients who underwent level I attended overnight polysomnography between 2009 and 2012. Electrocardiographic data collected during sleep studies of patients with and without OSA were manually reviewed. Results: The study comprised 498 patients (394 OSA patients and 104 non-OSA patients (controls)...
October 2017: Sleep Science
https://www.readbyqxmd.com/read/29387251/cardio-autonomic-functions-and-sleep-indices-before-and-after-coronary-artery-bypass-surgery
#5
Khamis Mohammed Al-Hashmi, Mohammed A Al-Abri, Deepali S Jaju, Mirdavron Mukaddirov, Abdulnasir Hossen, Mohammed O Hassan, Mostafa Mesbah, Hilal Ali Al-Sabti
BACKGROUND: Earlier studies showed a short-term impairment of cardio-autonomic functions following coronary artery bypass grafting (CABG). There is a lack of consistency in the time of recovery from this impairment. Studies have attributed the post-CABG atrial fibrillation to preexisting obstructive sleep apnea (OSA) without an objective sleep assessment. The aim of this study was to evaluate the effect of CABG on cardio-autonomic and hemodynamic functions and on OSA indices in patients with ischemic heart disease (IHD)...
January 2018: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29250279/baseline-demographics-safety-and-patient-acceptance-of-an-insertable-cardiac-monitor-for-atrial-fibrillation-screening-the-reveal-af-study
#6
Sergio Conti, James A Reiffel, Bernard J Gersh, Peter R Kowey, Rolf Wachter, Jonathan L Halperin, Rachelle E Kaplon, Erika Pouliot, Atul Verma
Given the high prevalence and risk of stroke associated with atrial fibrillation (AF), detection strategies have important public health implications. The ongoing prospective, single-arm, open-label, multicenter REVEAL AF trial is evaluating the incidence of previously undetected AF using an insertable cardiac monitor (ICM) in patients without prior AF or device implantation, but who could be at risk for AF due to their demographic characteristics, +/- non-specific but compatible symptoms. Enrollment required an elevated AF risk profile defined as CHADS2≥3 or CHADS2=2 plus one or more of the following: coronary artery disease, renal impairment, sleep apnea or chronic obstructive pulmonary disease...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250231/laser-catheter-ablation-of-long-lasting-persistent-atrial-fibrillation-longterm-results
#7
Helmut Weber, Michaela Sagerer-Gerhardt, Armin Heinze
Catheter ablation of atrial fibrillation (AF) is a current therapeutic option but its efficacy for the treatment of long-lasting persistent AF (l-lpAF) remains suboptimal. We tested the laser method as an alternative for catheter ablation of l-lpAF by using an open-irrigated electrode laser mapping and ablation (ELMA) catheter. Laser ablation was attempted in 48 patients aged 50-81 years (69 ± 7.6 y, female = 28) with drug resistant (3.5 trials) l-lpAF (≥12 months). All of the patients had comorbidities: congestive heart failure NYHA II-III (100%), hypertension 29 (60%), coronary artery disease 19 (40%), and heart valve defect 17 (35%)...
August 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29223500/impact-of-chronic-kidney-disease-on-mortality-in-adults-undergoing-balloon-aortic-valvuloplasty
#8
Puja B Parikh, Samantha Novotny, Allen Jeremias, Javed Butler, Jie Yang, Donglei Yin, Luis Gruberg
BACKGROUND: Balloon aortic valvuloplasty (BAV) is often utilized as a bridge prior to surgical or transcatheter aortic valve replacement. Chronic kidney disease (CKD) is commonly present in patients with aortic stenosis, however, its association with outcomes following BAV has not been well studied. Accordingly, we sought to assess the impact of CKD on mortality in adults undergoing BAV. METHODS: The Nationwide Inpatient Sample was screened for hospitalizations involving adults undergoing BAV from 2006 to 2012...
October 26, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29187390/phenotyping-of-sleep-disordered-breathing-in-patients-with-chronic-heart-failure-with-reduced-ejection-fraction-the-schlahf-registry
#9
Michael Arzt, Olaf Oldenburg, Andrea Graml, Erland Erdmann, Helmut Teschler, Karl Wegscheider, Anna Suling, Holger Woehrle
BACKGROUND: Different sleep-disordered breathing (SDB) phenotypes, including coexisting obstructive and central sleep apnea (OSA-CSA), have not yet been characterized in a large sample of patients with heart failure and reduced ejection fraction (HFrEF) receiving guideline-based therapies. Therefore, the aim of the present study was to determine the proportion of OSA, CSA, and OSA-CSA, as well as periodic breathing, in HFrEF patients with SDB. METHODS AND RESULTS: The German SchlaHF registry enrolled patients with HFrEF receiving guideline-based therapies, who underwent portable SDB monitoring...
November 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29171361/canadian-stroke-best-practice-recommendations-secondary-prevention-of-stroke-sixth-edition-practice-guidelines-update-2017
#10
Theodore Wein, M Patrice Lindsay, Robert Côté, Norine Foley, Joseph Berlingieri, Sanjit Bhogal, Aline Bourgoin, Brian H Buck, Jafna Cox, Dion Davidson, Dar Dowlatshahi, Jim Douketis, John Falconer, Thalia Field, Laura Gioia, Gord Gubitz, Jeffrey Habert, Sharon Jaspers, Cheemun Lum, Dana McNamara Morse, Paul Pageau, Mubeen Rafay, Amanda Rodgerson, Bill Semchuk, Mukul Sharma, Ashkan Shoamanesh, Arturo Tamayo, Elisabeth Smitko, David J Gladstone
The 2017 update of The Canadian Stroke Best Practice Recommendations for the Secondary Prevention of Stroke is a collection of current evidence-based recommendations intended for use by clinicians across a wide range of settings. The goal is to provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors. Recommendations include those related to diagnostic testing, diet and lifestyle, smoking, hypertension, hyperlipidemia, diabetes, antiplatelet and anticoagulant therapies, carotid artery disease, atrial fibrillation, and other cardiac conditions...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29167620/obstructive-sleep-apnea-independently-increases-the-incidence-of-heart-failure-and-major-adverse-cardiac-events-a-retrospective-population-based-follow-up-study
#11
Yu-Sheng Lin, Pi-Hua Liu, Pao-Hsien Chu
Background: Obstructive sleep apnea (OSA) is common in heart failure (HF) patients and exacerbates the outcome of this chronic disease. However, the frequency of HF arising from OSA is varied, with little supporting literature. Here, we aimed to clarify the incidence risk of HF and major adverse cardiac events (MACEs) in OSA patients from the Taiwan large database. Methods and Results: From 2000-2010, a total of 2699 newly diagnosed OSA patients after polysomnographic study and 13,490 non-OSA patients utilizing 1:5 matching was enrolled and followed to 2011...
November 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29144513/predictors-of-heart-rhythm-disturbances-in-hypertensive-obese-patients-with-obstructive-sleep-apnea
#12
Lyudmila Sergeevna Korostovtseva, Nadezhda Edvinovna Zvartau, Oxana Petrovna Rotar, Yurii Vladimirovich Sviryaev, Aleksandra Olegovna Konradi
Objective: To assess the incidence and predictors of heart rhythm and conduction disturbances in hypertensive obese patients with and without obstructive sleep apnea (OSA). Methods: This is an open, cohort, prospective study. Out of 493 screened patients, we selected 279 hypertensive, obese individuals without severe concomitant diseases: 75 patients without sleep-disordered breathing (non-SDB group), and 204 patients with OSA (OSA group). At baseline, all patients underwent examination, including ECG, Holter ECG monitoring, and sleep study...
September 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29133382/atrial-fibrillation-and-obstructive-sleep-apnea-beyond-the-pulmonary-veins
#13
EDITORIAL
Konstantinos C Siontis, Hakan Oral
No abstract text is available yet for this article.
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29133380/atrial-substrate-and-triggers-of-paroxysmal-atrial-fibrillation-in-patients-with-obstructive-sleep-apnea
#14
MULTICENTER STUDY
Elad Anter, Luigi Di Biase, Fernando M Contreras-Valdes, Carola Gianni, Sanghamitra Mohanty, Cory M Tschabrunn, Juan F Viles-Gonzalez, Eran Leshem, Alfred E Buxton, Guy Kulbak, Rim N Halaby, Peter J Zimetbaum, Jonathan W Waks, Robert J Thomas, Andrea Natale, Mark E Josephson
BACKGROUND: Obstructive sleep apnea (OSA) is associated with atrial remodeling, atrial fibrillation (AF), and increased incidence of arrhythmia recurrence after pulmonary vein (PV) isolation. We aimed to characterize the atrial substrate, including AF triggers in patients with paroxysmal AF and OSA. METHODS AND RESULTS: In 86 patients with paroxysmal AF (43 with ≥moderate OSA [apnea-hypopnea index ≥15] and 43 without OSA [apnea-hypopnea index <5]), right atrial and left atrial voltage distribution, conduction velocities, and electrogram characteristics were analyzed during atrial pacing...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29109195/sleep-apnea-and-cardiovascular-disease-lessons-from-recent-trials-and-need-for-team-science
#15
REVIEW
Luciano F Drager, R Doug McEvoy, Ferran Barbe, Geraldo Lorenzi-Filho, Susan Redline
Emerging research highlights the complex interrelationships between sleep-disordered breathing and cardiovascular disease, presenting clinical and research opportunities as well as challenges. Patients presenting to cardiology clinics have a high prevalence of obstructive and central sleep apnea associated with Cheyne-Stokes respiration. Multiple mechanisms have been identified by which sleep disturbances adversely affect cardiovascular structure and function. Epidemiological research indicates that obstructive sleep apnea is associated with increases in the incidence and progression of coronary heart disease, heart failure, stroke, and atrial fibrillation...
November 7, 2017: Circulation
https://www.readbyqxmd.com/read/29101955/cardioversions-and-transthoracic-echocardiography
#16
REVIEW
Ronak Shah, Elizabeth Zhou
Patients with atrial fibrillation and flutter routinely require transesophageal echocardiography with cardioversion. It is not uncommon to encounter patients with reduced ejection fractions, coronary artery disease, prior cardiac surgery, or obstructive sleep apnea. The anesthesiologist must carefully evaluate the patient and any available laboratory and study findings to assess for potential complications after anesthesia. Appropriate anesthetics must be chosen based on the preoperative evaluation. Additionally, because most of these cases are done without a secured airway, emergency medications and airway equipment must be readily available...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29097705/metoprolol-prevents-chronic-obstructive-sleep-apnea-induced-atrial-fibrillation-by-inhibiting-structural-sympathetic-nervous-and-metabolic-remodeling-of-the-atria
#17
Li Sun, Sen Yan, Xiaoyu Wang, Shiqi Zhao, Hui Li, Yike Wang, Shuang Lu, Xinwen Dong, Jing Zhao, Shengzhu Yu, Minghui Li, Yue Li
Chronic obstructive sleep apnea (OSA) may promote the development of atrial fibrillation (AF) by inducing atrial electrical and structural remodeling as well as autonomic nerve hyperinnervation. Here, we investigated the roles of metoprolol in regulation of atrial remodeling induced by chronic OSA. A canine model of chronic OSA was established by stopping the ventilator and closing the airway for 4 h/day every other day for 12 weeks, while metoprolol (5 mg·kg-1·day-1) was continuously administered. Using that model, we observed that increases in sympathetic sprouting and atrial structural remodeling were sharply inhibited by metoprolol...
November 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29049073/postoperative-outcomes-in-obstructive-sleep-apnea-patients-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis-of-comparative-studies
#18
Mahesh Nagappa, George Ho, Jayadeep Patra, Jean Wong, Mandeep Singh, Roop Kaw, Davy Cheng, Frances Chung
BACKGROUND: Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing cardiac surgery and may predispose patients to postoperative complications. The purpose of this meta-analysis is to determine the evidence of postoperative complications associated with OSA patients undergoing cardiac surgery. METHODS: A literature search of Cochrane Database of Systematic Reviews, Medline, Medline In-process, Web of Science, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL until October 2016 was performed...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049041/the-impact-of-lifestyle-intervention-on-atrial-fibrillation
#19
Kathryn L Hong, Benedict M Glover
PURPOSE OF REVIEW: Atrial fibrillation is the most common sustained cardiac arrhythmia, attributable to several factors that may be amenable through lifestyle modification. There is emerging evidence to suggest that the successful management of several cardiovascular risk factors [obesity, hypertension (HTN), diabetes mellitus, and obstructive sleep apnea (OSA)] can lead to fewer complications and atrial fibrillation prevention. However, the long-term sustainability and reproducibility of these effects have yet to be explored in larger studies...
January 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29029984/sleep-sleep-apnea-and-atrial-fibrillation-questions-and-answers
#20
REVIEW
Younghoon Kwon, Ryan J Koene, Alan D Johnson, Gen-Min Lin, John D Ferguson
Sleep apnea (SA) is a common sleep disorder increasingly recognized as a risk for cardiovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. An increasing number of investigations in recent years have linked SA to AF. In this review, we aim to provide a critical overview of the existing evidence in a question and answer format by addressing the following: What is the prevalent association between the two conditions (separating nocturnally detected AF episodes from AF as a prevalent condition)? Is SA a risk factor for incident AF? Is SA a risk factor for recurrence of AF following cardioversion/catheter-based ablation? What is the association between SA and AF in patients with heart failure? Are there signature electrocardiographic markers of AF found in patients with SA? Are there electrophysiology-based studies supporting the link between SA and AF? What other sleep characteristics (beyond SA) are found in patients with AF? What is the impact of SA treatment on AF? What is the effect of AF treatment on sleep? Finally, we address unsolved questions and suggest future directions to enhance our understanding of the AF-SA relationship...
September 4, 2017: Sleep Medicine Reviews
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