Strategies to manage obstructive sleep apnea to decrease the burden of atrial fibrillation.

Strategies to manage obstructive sleep apnea to decrease the burden of atrial fibrillation. Expert Rev Cardiovasc Ther. 2018 Aug 23;: Authors: Goes CM, Pretti P, Drager LF Abstract INTRODUCTION: In the last decades, consistent data derived from experimental, epidemiological and clinical studies pointed Obstructive Sleep Apnea (OSA), the most common sleep disordered breathing worldwide, as a potential risk factor for incidence and recurrence of atrial fibrillation (AF). Areas covered: This review article describes the impact of OSA on AF and discusses potential strategies for managing OSA in the AF scenario. Expert commentary: Untreated OSA seems to be one important predictor of AF treatment failure after chemical or electrical cardioversion as well as after a successful AF ablation. There is biological plausibility for this association including the effects of intermittent hypoxia and sleep fragmentation promoting sympathetic activation, blood pressure instability, inflammation and oxidative stress. The negative swings derived from the obstructive events also increases left ventricle afterload contributing to cardiac remodeling. Altogether, these factors provide a structural and electrical substrate for AF. Despite this evidence, however, OSA remains still poorly recognized and consequently undertreated in clinical practice. Therefore, active programs to incorporate valid screening for cardiologists to work in partnership to sleep me...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research