Cardiac Remodeling in Patients with Atrial Fibrillation and Obstructive Sleep Apnea
Study Overview
Obstructive sleep apnea (OSA) can affect heart structure, specifically the left atrium (LA) and left ventricle (LV), which are linked to atrial fibrillation (AF). This study explored whether using continuous positive airway pressure (CPAP) can improve heart structure in patients with OSA and paroxysmal AF (PAF).
Methodology
We conducted a randomized controlled trial with patients diagnosed with PAF. Those with an Apnea-Hypopnea Index of 15 or more per hour were included. We monitored AF using an implantable loop recorder and randomly assigned patients to either CPAP treatment or standard care. Echocardiograms were performed at the start, and again after 6 and 12 months, to measure heart function and structure.
Results
A total of 109 patients (average age 63, average BMI 29.6, 76% men) participated. Of these, 83 were scheduled for pulmonary vein isolation (PVI) and 26 for clinical follow-up only. 55 patients received CPAP and 54 received standard care. The burden of AF decreased in those who had PVI, regardless of whether they used CPAP. However, no significant improvements were found in heart function or structure for either group over the 12 months.
Conclusion
In patients with PAF and OSA, using CPAP did not show any improvement in heart structure within 12 months.
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