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Osas paroxysmal atrial fibrillation

Nika Karimi, Marta Kelava, Perin Kothari, Nicole M Zimmerman, A Marc Gillinov, Andra E Duncan
BACKGROUND: Patients with obstructive sleep apnea (OSA) experience intermittent hypoxia, hypercarbia, and sympathetic activation during sleep, which increases risk for paroxysmal atrial fibrillation and other cardiac arrhythmias. Whether patients with OSA experience increased episodes of atrial fibrillation after cardiac surgery is unclear. We examined whether patients at increased risk for OSA, assessed by the STOP-BANG (snoring, tired during the day, observed stop breathing during sleep, high blood pressure, body mass index more than 35 kg/m, age more than 50 years, neck circumference more than 40 cm, and male gender) questionnaire, had a higher incidence of new-onset postoperative atrial fibrillation after cardiac surgery...
June 2018: Anesthesia and Analgesia
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
Bhradeev Sivasambu, Muhammad A Balouch, Tarek Zghaib, Rizma J Bajwa, Jonathan Chrispin, Ronald D Berger, Hiroshi Ashikaga, Saman Nazarian, Joseph E Marine, Hugh Calkins, David D Spragg
INTRODUCTION: Catheter ablation is common for patients with symptomatic, drug-refractory atrial fibrillation (AF). Obesity is a known risk factor for incident AF. The impact of obesity on AF ablation outcomes is incompletely understood. We sought to determine the impact of elevated body mass index (BMI) on pulmonary vein isolation (PVI) procedural outcomes and associated complications. METHODS AND RESULTS: We evaluated patients undergoing PVI from 2001 to 2015, dividing them into four groups: normal weight (BMI ≥ 18...
November 13, 2017: Journal of Cardiovascular Electrophysiology
Jorge Romero, Carola Gianni, Andrea Natale, Luigi Di Biase
Special attention must be paid to detect, diagnose, and optimize management of reversible or treatable causes of long-standing persistent atrial fibrillation (LSPAF) such as obesity, obstructive sleep apnea (OSA), hypertension, hypo or hyperthyroidism, inflammatory and infectious diseases, and stress. Though, we strongly believe that the role of the pulmonary veins (PVs) is more pronounced in paroxysmal atrial fibrillation (AF) than in persistent AF, performing an adequate pulmonary vein isolation is still key in LSPAF...
May 2017: Current Treatment Options in Cardiovascular Medicine
Chung-Yao Chen, Chien-Hui Ho, Chia-Ling Chen, Chung-Chieh Yu
STUDY OBJECTIVES: Both atrial fibrillation (AF) and obstructive sleep apnea (OSA) are risk factors for ischemic stroke. Previous studies suggested that OSA is associated with AF in individuals who have not had a stroke. For better secondary prevention of stroke, this study determined the association between OSA and AF among patients with ischemic stroke. METHODS: This cross-sectional study recruited consecutive patients with subacute ischemic stroke admitted for neurorehabilitation...
May 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Jacek Wolf, Tadeusz Dereziński, Anna Szyndler, Krzysztof Narkiewicz
BACKGROUND: Atrial fibrillation (AF) constitutes the most prevalent arrhythmia, affecting up-to 2% of the general population. Apart from well-established risk factors that increase the odds for the development of AF, e.g. age or arterial hypertension, recent analyses indicate that obstructive sleep apnoea (OSA) may independently, negatively modify the arrhythmia occur-rence profile. Concurrently, erectile dysfunction (ED) is a commonly neglected, potent marker of cardiovascular risk, which considerably worsens men's psychological state...
2017: Kardiologia Polska
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
Melissa C Lipford, Kelly D Flemming, Andrew D Calvin, Jay Mandrekar, Robert D Brown, Virend K Somers, Sean M Caples
STUDY OBJECTIVES: To assess etiology of ischemic stroke in patients with obstructive sleep apnea (OSA) compared with controls. This information may aid in determining how OSA increases stroke risk and facilitate recurrent stroke prevention in patients with OSA. DESIGN: Retrospective, case-control study. SETTING: Academic tertiary referral center. PATIENTS: Consecutive patients who underwent polysomnography and had an ischemic stroke within 1 year were identified...
November 1, 2015: Sleep
Peter M Farrehi, Louise M O'Brien, Hatice Duygu Bas, Kazim Baser, Krit Jongnarangsin, Rakesh Latchamsetty, Hamid Ghanbari, Thomas Crawford, Frank Bogun, Eric Good, Frank Pelosi, Aman Chugh, Fred Morady, Hakan Oral
BACKGROUND: Recurrent atrial fibrillation (AF) after successful cardioversion can be predicted by obstructive sleep apnea (OSA) diagnosed by polysomnography. However, it is not known whether the validated STOP-BANG questionnaire can predict AF recurrence after radiofrequency ablation (RFA). Our objective is to determine the prevalence of unrecognized OSA in patients with AF and its relation to freedom from AF after RFA. METHODS: Validated surveys were administered to 247 consecutive AF patients following radiofrequency ablation from January to October 2011...
September 2015: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Christian Schlatzer, Esther I Schwarz, Noriane A Sievi, Christian F Clarenbach, Thomas Gaisl, Laurent M Haegeli, Firat Duru, John R Stradling, Malcolm Kohler
AIMS: There is preliminary evidence for a link between obstructive sleep apnoea (OSA) and arrhythmias such as paroxysmal atrial fibrillation (PAF) and sudden cardiac death but underlying mechanisms remain largely unknown. METHODS AND RESULTS: In this interventional crossover study, we evaluated whether intrathoracic pressure changes, induced by simulated OSA, trigger premature cardiac beats, and alter measures of ventricular repolarization [QTc and Tpeak-to-Tend (TpTec) intervals] in patients with PAF...
January 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Hwan-Cheol Park, Yonggu Lee, DaeIn Lee, Yae Min Park, Jaemin Shim, Ji-Eun Ban, Jong-Il Choi, Sang-Weon Park, Young-Hoon Kim
Left arial (LA) function, defined according to conduit, reservoir and booster functions, is closely linked to left ventricular (LV) mechanics, particularly during diastole. Right ventricular pacing (RVP) is thought to impair LA diastolic restoring forces through alteration of ventricular activation. The aim of this study was to determine whether the LA functional reservoir estimated as the change in mean LA ejection fraction (EF) immediately after RVP, and for the second and for the third beats after RVP, predicts clinical outcome in patients with paroxysmal atrial fibrillation (AF) who have undergone catheter ablation (CA)...
December 2014: International Journal of Cardiovascular Imaging
Mathias Hohl, Benedikt Linz, Michael Böhm, Dominik Linz
Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with relevant morbidity and mortality. Besides hypertension, valvular disease and cardiomyopathy, mainly ischemic and dilated, also other conditions like obesity, alcohol abusus, genetic factors and obstructive sleep apnea (OSA) are discussed to contribute to the progression from paroxysmal to persistent AF. The prevalence of OSA among patients with AF is 40-50%. OSA is characterized by periodic or complete cessation of effective breathing during sleep due to obstruction of the upper airways...
November 2014: Current Cardiology Reviews
Sanghamitra Mohanty, Prasant Mohanty, Luigi DI Biase, Rong Bai, Chintan Trivedi, Pasquale Santangeli, Francesco Santoro, Richard Hongo, Steven Hao, Salwa Beheiry, David Burkhardt, Joseph G Gallinghouse, Rodney Horton, Javier E Sanchez, Shane Bailey, Patrick M Hranitzky, Jason Zagrodzky, Andrea Natale
INTRODUCTION: Metabolic syndrome (MS) and obstructive sleep apnea (OSA) are well-known independent risk factors for atrial fibrillation (AF) recurrence. This study evaluated ablation outcome in AF patients with coexistent MS and OSA and influence of lifestyle modifications (LSM) on arrhythmia recurrence. METHODS AND RESULTS: We included 1,257 AF patients undergoing first catheter ablation (30% paroxysmal AF). Patients having MS + OSA were classified into Group 1 (n = 126; 64 ± 8 years; 76% male)...
September 2014: Journal of Cardiovascular Electrophysiology
Arijit Chanda, Armand Wolff, Craig McPherson, Jeff Kwon
BACKGROUND: The relationship between obstructive sleep apnea (OSA) and increased risk for atrial fibrillation (AF) has been well established in previous studies. The relationship between OSA and silent AF is unknown. We hypothesized that patients with OSA but no known history of AF are at an increased risk for the arrhythmia and may be detectable by prolonged electrocardiogram (ECG) monitoring. In this study, we examined whether 7 days of extended cardiac monitoring with an ECG event recorder is an effective screening tool to detect intermittent, silent AF in patients with severe OSA...
March 2015: Sleep & Breathing, Schlaf & Atmung
Filip M Szymański, Anna E Płatek, Grzegorz Karpiński, Edward Koźluk, Bartosz Puchalski, Krzysztof J Filipiak
BACKGROUND: Obstructive sleep apnoea (OSA) and atrial fibrillation (AF) are two conditions highly prevalent in the general population. OSA is known to cause haemodynamic changes, oxidative stress, and endothelial damage, and therefore promote vascular and heart remodelling which results in AF triggering and exacerbation. Coexistence of OSA and AF influences the course of both diseases, and therefore should be taken into consideration in patient management strategy planning. AIM: To assess the prevalence of OSA in Polish AF patients, and to describe the clinical characteristics of patients with concomitant OSA and AF...
2014: Kardiologia Polska
Vishal Patel, Ruchi Bansal, Jeremy Weingarten
SESSION TYPE: Cardiovascular Case Report PostersPRESENTED ON: Monday, October 22, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: There is a well-known pathophysiologic and epidemiologic relationship between obstructive sleep apnea (OSA) and atrial fibrillation (AF). [1] We present the first description of brief paroxysms of AF temporally associated with discrete obstructive events in an individual with no known cardiovascular disease.CASE PRESENTATION: A 43 year-old man with no significant past medical history was referred for evaluation of snoring, excessive daytime sleepiness, and witnessed apneas...
October 1, 2012: Chest
Hany Dimitri, Michelle Ng, Anthony G Brooks, Pawel Kuklik, Martin K Stiles, Dennis H Lau, Nicholas Antic, Andrew Thornton, David A Saint, Doug McEvoy, Ral Antic, Jonathan M Kalman, Prashanthan Sanders
BACKGROUND: There is a known association between obstructive sleep apnea (OSA) and atrial fibrillation (AF); however, how OSA affects the atrial myocardium is not well described. OBJECTIVE: To determine whether patients with OSA have an abnormal atrial substrate. METHODS: Forty patients undergoing ablation of paroxysmal AF and in sinus rhythm (20 with OSA [apnea-hypopnea index ≥ 15] and 20 reference patients with no OSA [apnea-hypopnea index < 15] by polysomnography) were studied...
March 2012: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Friedrich Felix Hoyer, Lars Martin Lickfett, Erica Mittmann-Braun, Charlotte Ruland, Jens Kreuz, Stefan Pabst, Jan Schrickel, Uwe Juergens, Selcuk Tasci, Georg Nickenig, Dirk Skowasch
OBJECTIVES: To address the question whether obstructive sleep apnea (OSA) is associated with the recurrence of paroxysmal atrial fibrillation (AF) in patients treated with ≥2 pulmonary vein isolation procedures. PATIENTS AND METHODS: In this study, we included adults with therapy-resistant symptomatic paroxysmal AF, defined as AF recurring after ≥2 PV-isolation procedures (n = 23). For comparison, we selected another cohort of patients being successfully treated by one PV isolation without AF recurrence within 6 months (n = 23)...
October 2010: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Dimpi Patel, Prasant Mohanty, Luigi Di Biase, Mazen Shaheen, William R Lewis, Kara Quan, Jennifer E Cummings, Paul Wang, Amin Al-Ahmad, Preeti Venkatraman, Eyad Nashawati, Dhanunjaya Lakkireddy, Robert Schweikert, Rodney Horton, Javier Sanchez, Joseph Gallinghouse, Steven Hao, Salwa Beheiry, Deb S Cardinal, Jason Zagrodzky, Robert Canby, Shane Bailey, J David Burkhardt, Andrea Natale
BACKGROUND: Obstructive sleep apnea (OSA) may be associated with pulmonary vein antrum isolation (PVAI) failure. The aim of the present study was to investigate if treatment with continuous positive airway pressure (CPAP) improved PVAI success rates. METHODS AND RESULTS: From January 2004 to December 2007, 3000 consecutive patients underwent PVAI. Patients were screened for OSA and CPAP use. Six hundred forty (21.3%) patients had OSA. Patients with OSA had more procedural failures (P=0...
October 2010: Circulation. Arrhythmia and Electrophysiology
Giovanni Cioffi, Tiziano Edoardo Russo, Carlo Stefenelli, Alessandro Selmi, Francesco Furlanello, Dana Cramariuc, Eva Gerdts, Giovanni de Simone
BACKGROUND: Obstructive sleep apnea (OSA) has several negative effects on the heart including increase in myocardial end-systolic stress, venous return and sympathetic activity, all potential stimuli of left ventricular (LV) hypertrophy. The impact of the severity of OSA on LV geometry is unknown. We hypothesized that OSA is related to concentric LV geometry. METHODS: One hundred and fifty-seven patients with suspected OSA underwent echocardiography, ambulatory 24-h blood pressure and ECG monitoring...
May 2010: Journal of Hypertension
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