CPAP use in OSA patients leads to reverse atrial remodeling, may reduce AF burden, SLEEP-AF study.
The association of atrial fibrillation (AF) with obstructive sleep apnea (OSA) is highly prevalent, yet remains pathophysiologically enigmatic. Although continuous positive airway pressure (CPAP) therapy is one of the most effective strategies to manage symptoms of OSA, its impact on atrial arrhythmogenicity has not been studied in randomized trials.
However, the results of a randomized trial- the SLEEP AF study, published recently in JACC CE, has shed light on this topic and shown that CPAP therapy results in reversal of atrial remodeling in AF. This provides mechanistic evidence advocating for management of OSA in AF.
The study team recruited 24 OSA patients to undergo baseline right atrial electrophysiologic mapping, followed by randomization to either CPAP therapy or no OSA therapy. After >6 months, these patients underwent a repeat invasive right atrial mapping study.
Outcome variables were atrial voltage (mV), conduction velocity (m/s), atrial surface area <0.5 mV (%), proportion of complex points (%), and atrial effective refractory periods (ms). Change between groups over time was compared.
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