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Association of atrial fibrillation and obstructive sleep apnea.
Circulation. 2004 Jul 27; 110(4):364-7.Circ

Abstract

BACKGROUND

Obstructive sleep apnea (OSA) is associated with recurrent atrial fibrillation (AF) after electrocardioversion. OSA is highly prevalent in patients who are male, obese, and/or hypertensive, but its prevalence in patients with AF is unknown.

METHODS AND RESULTS

We prospectively studied consecutive patients undergoing electrocardioversion for AF (n=151) and consecutive patients without past or current AF referred to a general cardiology practice (n=312). OSA was diagnosed with the Berlin questionnaire, which is validated to identify patients with OSA. We also assessed its accuracy compared with polysomnography in a sample of the study population. Groups were compared with the 2-tailed t, Wilcoxon, and chi2 tests. Logistic regression modeled the association of AF and OSA after adjustment for relevant covariates. Patients in each group had similar age, gender, body mass index, and rates of diabetes, hypertension, and congestive heart failure. The questionnaire performed with 0.86 sensitivity, 0.89 specificity, and 0.97 positive predictive value in our sample. The proportion of patients with OSA was significantly higher in the AF group than in the general cardiology group (49% versus 32%, P=0.0004). The adjusted odds ratio for the association between AF and OSA was 2.19 (95% CI 1.40 to 3.42, P=0.0006).

CONCLUSIONS

The novel finding of this study is that a strong association exists between OSA and AF, such that OSA is strikingly more prevalent in patients with AF than in high-risk patients with multiple other cardiovascular diseases. The coinciding epidemics of obesity and AF underscore the clinical importance of these results.

Authors+Show Affiliations

Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, 200 First St SW, Rochester, Minn 55905, USA. somers.virend@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15249509

Citation

Gami, Apoor S., et al. "Association of Atrial Fibrillation and Obstructive Sleep Apnea." Circulation, vol. 110, no. 4, 2004, pp. 364-7.
Gami AS, Pressman G, Caples SM, et al. Association of atrial fibrillation and obstructive sleep apnea. Circulation. 2004;110(4):364-7.
Gami, A. S., Pressman, G., Caples, S. M., Kanagala, R., Gard, J. J., Davison, D. E., Malouf, J. F., Ammash, N. M., Friedman, P. A., & Somers, V. K. (2004). Association of atrial fibrillation and obstructive sleep apnea. Circulation, 110(4), 364-7.
Gami AS, et al. Association of Atrial Fibrillation and Obstructive Sleep Apnea. Circulation. 2004 Jul 27;110(4):364-7. PubMed PMID: 15249509.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of atrial fibrillation and obstructive sleep apnea. AU - Gami,Apoor S, AU - Pressman,Gregg, AU - Caples,Sean M, AU - Kanagala,Ravi, AU - Gard,Joseph J, AU - Davison,Diane E, AU - Malouf,Joseph F, AU - Ammash,Naser M, AU - Friedman,Paul A, AU - Somers,Virend K, Y1 - 2004/07/12/ PY - 2004/7/14/pubmed PY - 2005/1/26/medline PY - 2004/7/14/entrez SP - 364 EP - 7 JF - Circulation JO - Circulation VL - 110 IS - 4 N2 - BACKGROUND: Obstructive sleep apnea (OSA) is associated with recurrent atrial fibrillation (AF) after electrocardioversion. OSA is highly prevalent in patients who are male, obese, and/or hypertensive, but its prevalence in patients with AF is unknown. METHODS AND RESULTS: We prospectively studied consecutive patients undergoing electrocardioversion for AF (n=151) and consecutive patients without past or current AF referred to a general cardiology practice (n=312). OSA was diagnosed with the Berlin questionnaire, which is validated to identify patients with OSA. We also assessed its accuracy compared with polysomnography in a sample of the study population. Groups were compared with the 2-tailed t, Wilcoxon, and chi2 tests. Logistic regression modeled the association of AF and OSA after adjustment for relevant covariates. Patients in each group had similar age, gender, body mass index, and rates of diabetes, hypertension, and congestive heart failure. The questionnaire performed with 0.86 sensitivity, 0.89 specificity, and 0.97 positive predictive value in our sample. The proportion of patients with OSA was significantly higher in the AF group than in the general cardiology group (49% versus 32%, P=0.0004). The adjusted odds ratio for the association between AF and OSA was 2.19 (95% CI 1.40 to 3.42, P=0.0006). CONCLUSIONS: The novel finding of this study is that a strong association exists between OSA and AF, such that OSA is strikingly more prevalent in patients with AF than in high-risk patients with multiple other cardiovascular diseases. The coinciding epidemics of obesity and AF underscore the clinical importance of these results. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15249509/Association_of_atrial_fibrillation_and_obstructive_sleep_apnea_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000136587.68725.8E?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -