Association of overlap syndrome with incident atrial fibrillation

AbstractIncreasingly compelling data link chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) to cardiovascular complications independent of known comorbidities. It remains unclear whether the association is amplified in the presence of both conditions. The aims of this study are to assess the prevalence of atrial fibrillation (AF) in overlap syndrome (OS) and to identify risk factors predisposing to this atrial arrhythmia. We conducted a retrospective cohort study of 268 adults without past or current AF who were referred for an initial diagnostic polysomnogram from 2012 to 2019. A logistic regression analysis was performed to identify risk factors for incident AF. Incident AF occurred in 64 subjects [cumulative probability 24%, 95% confidence interval (CI) 19 –29]. Independent predictors of incident AF were age-adjusted Charlson index [Odds ratio (OR) 1.62; 95% confidence interval (CI) 1.3–2.0], percentage of time spent with O2 saturation below 90% (CT90) (OR 3.72, 95% CI 1.18 –11.71), and CPAP adherence (OR 0.32, 95% CI 0.13–0.71). OS patients with AF experienced higher hospitalization rates (OR 1.25, 95% CI 1.03–2.37) and worse mortality rates (OR 1.92, 95% CI 1.04–3.54). In multivariate Cox proportional regression, age-adjusted Charlson Index, severity of airfl ow obstruction, and CPAP adherence were independent predictors of mortality. The burden of hypoxemia and severity of comorbidities are independent fac...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research

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Source: Journal of Toxicology and Environmental Health Part A - Category: Environmental Health Authors: Source Type: research
Acceptance of trauma can also help to reduce its damaging effects. → Support PsyBlog for just $5 per month. Enables access to articles marked (M) and removes ads. → Explore PsyBlog's ebooks, all written by Dr Jeremy Dean: Accept Yourself: How to feel a profound sense of warmth and self-compassion The Anxiety Plan: 42 Strategies For Worry, Phobias, OCD and Panic Spark: 17 Steps That Will Boost Your Motivation For Anything Activate: How To Find Joy Again By Changing What You Do
Source: PsyBlog | Psychology Blog - Category: Psychiatry & Psychology Authors: Tags: Sleep subscribers-only Source Type: blogs
Publication date: Available online 10 October 2020Source: IJC Heart &VasculatureAuthor(s): Dominik Linz, Jeroen Hendriks
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research
Authors: Tsujioka S, Nozoe M, Kawano Y, Suematsu N, Kubota T Abstract A 70-year-old woman with situs inversus totalis underwent catheter ablation for atrial fibrillation and atrial flutter. Although her morphologic left atrium (LA) was enlarged, we performed cryoballoon ablation and liner radiofrequency ablation of the cava-tricuspid isthmus without mapping atrial arrhythmias. However, a different form of atrial tachycardia (AT) recurred. We performed catheter ablation a second time using a three-dimensional electroanatomic mapping system. AT was not terminated by the liner ablation at the roof of morphologic LA an...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Background: Obesity is strongly associated with both Blount disease and obstructive sleep apnea (OSA). Obesity increases risks for anesthetic and postoperative complications, and OSA can further exacerbate these risks. Since children with Blount disease might have both conditions, we sought to determine the perioperative complications and the prevalence of OSA among these children. Methods: Patients younger than 18 years undergoing corrective surgery for Blount disease were identified from 2 sources as follows: a retrospective review of records at a single institution and querying of the Kids’ Inpatient Database...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Knee Source Type: research
Kirchhof and colleagues et al. (N Engl J Med. 2020;383(14):1305-1316 PMID: 32865375) randomized patients with early atrial fibrillation (AF) to rhythm control or usual care. The first primary outcome was a composite of cardiovascular death, stroke, or hospitalization with heart failure heart failure or coronary syndrome. The second primary outcome was the number of nights spent in the hospital. The trial was stopped for efficacy after a median of 5.1 years of follow-up of 2789 patients. A first-primary-outcome event occurred in 249 patients with rhythm control (3.9/100 person-years) and in 316 patients with usual care (5.0...
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research
AbstractPurpose of ReviewElectrocardiography (ECG) and echocardiography are the most widely used diagnostic tools in clinical cardiology. This review focuses on recent advancements in applying machine learning (ML) in ECG and echocardiography and potential synergistic ML integration of ECG and echocardiography.Recent FindingsML algorithms have been used in ECG for technical quality assurance, arrhythmia identification, and prognostic predictions, and in echocardiography to recognize image views, quantify measurements, and identify pathologic patterns. Synergistic application of ML in ECG and echocardiograph has demonstrate...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
AbstractPurpose of reviewCatheter ablation has emerged as the most effective long-term rhythm controlling strategy in patients with symptomatic atrial fibrillation (AF). Over the last few years, the role of ablation has shifted from a last-resort strategy toward a first-line approach in AF management. The purpose of this review is to highlight the rationale behind an early ablation strategy and to summarize recent data regarding its effectiveness.Recent findingsPulmonary vein isolation (PVI), the cornerstone of catheter ablation of AF, is superior to antiarrhythmic drugs (AADs) in preventing recurrence of AF. PVI is most e...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
AbstractPurpose of reviewAtrial fibrillation is the commonest sustained arrhythmia in rheumatic heart disease and is associated with significant morbidity and mortality. In this review, we discuss its epidemiology, natural course and management with special emphasis on recent developments in understanding and treatment of atrial fibrillation in rheumatic heart disease.Recent findingsUse of direct oral anticoagulants appears promising, especially in developing countries where regular coagulation monitoring is a challenge. Also, restoration and maintenance of sinus rhythm in rheumatic atrial fibrillation appear feasible and ...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
We examined the relationship between newly diagnosed obstructive sleep apnea (OSA) and incident hospitalized atrial fibrillation (AF) over the subsequent ten years in a large arrhythmia-free cohort. METHODS: Adults referred between 1994 and 2010 to a large academic hospital with suspected OSA who were arrhythmia-free at the time of first diagnostic sleep study were included. Clinical data were linked to provincial health administrative data to define outcome. We used Cox regressions to investigate the relationship between OSA severity as measured by the apnea-hypopnea index (AHI) and degree of nocturnal hypoxemia, and...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
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