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Low efficacy of atrial fibrillation ablation in severe obstructive sleep apnoea patients.
Europace. 2010 Aug; 12(8):1084-9.E

Abstract

AIMS

Atrial fibrillation (AF) ablation efficacy varies according to patients' clinical characteristics. Although the association of obstructive sleep apnoea (OSA) and AF is well established, data on AF ablation efficacy in OSA are scarce. The aim of this study was to clarify the effect of OSA on the outcome of AF ablation.

METHODS AND RESULTS

A series of 174 consecutive patients without polysomnography submitted to circumferential pulmonary vein ablation were included in the study. All patients were assessed by Berlin Questionnaire (BQ) and underwent an echocardiogram and a clinical evaluation. Patients with a high BQ score, indicating high risk for OSA, participated in a sleep study. Diagnoses were classified according to the apnoea-hypoapnoea index (AHI) as mild (AHI < 10/h), non-severe (AHI < 30/h), or severe (AHI >or= 30/h) OSA. Follow-up consisted of outpatient visits and 24 or 48 h Holter monitoring at 1, 4, and 7 months, and every 6 months thereafter. Any episode of AF or left atrial (LA) flutter was considered recurrence. Fifty-one (29.3%) patients had high BQ scores. The sleep study showed that 17 (9.8%) and 25 (14.4%) of these patients had non-severe and severe OSA, respectively. One-year arrhythmia-free probability after a single ablation procedure was 48.5% in patients with low risk for OSA (low BQ score or AHI < 10/h), 30.4% in the non-severe OSA group (10 < AHI < 30/h) and 14.3% in the severe OSA group (AHI >or= 30). Anteroposterior LA diameter [hazard ratio (HR) = 1.046, 95% confidence interval (CI): 1.005-1.089; P = 0.029] and severe OSA (HR = 1.870, 95% CI: 1.106-3.161; P = 0.019) were the independent predictors of arrhythmia recurrence.

CONCLUSION

In patients with AF ablation, the presence of severe OSA is an independent predictor for AF ablation failure.

Authors+Show Affiliations

Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Clínic Universitari, Institut de Investigació Biomèdica August Pi i Sunyer, University of Barcelona, 08036 Barcelona, Catalonia, Spain.No 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)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20488856

Citation

Matiello, Maria, et al. "Low Efficacy of Atrial Fibrillation Ablation in Severe Obstructive Sleep Apnoea Patients." Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, vol. 12, no. 8, 2010, pp. 1084-9.
Matiello M, Nadal M, Tamborero D, et al. Low efficacy of atrial fibrillation ablation in severe obstructive sleep apnoea patients. Europace. 2010;12(8):1084-9.
Matiello, M., Nadal, M., Tamborero, D., Berruezo, A., Montserrat, J., Embid, C., Rios, J., Villacastín, J., Brugada, J., & Mont, L. (2010). Low efficacy of atrial fibrillation ablation in severe obstructive sleep apnoea patients. Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, 12(8), 1084-9. https://doi.org/10.1093/europace/euq128
Matiello M, et al. Low Efficacy of Atrial Fibrillation Ablation in Severe Obstructive Sleep Apnoea Patients. Europace. 2010;12(8):1084-9. PubMed PMID: 20488856.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low efficacy of atrial fibrillation ablation in severe obstructive sleep apnoea patients. AU - Matiello,Maria, AU - Nadal,Mercé, AU - Tamborero,David, AU - Berruezo,Antonio, AU - Montserrat,Josep, AU - Embid,Cristina, AU - Rios,Jose, AU - Villacastín,Julián, AU - Brugada,Josep, AU - Mont,Lluís, Y1 - 2010/05/20/ PY - 2010/5/22/entrez PY - 2010/5/22/pubmed PY - 2010/11/17/medline SP - 1084 EP - 9 JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology JO - Europace VL - 12 IS - 8 N2 - AIMS: Atrial fibrillation (AF) ablation efficacy varies according to patients' clinical characteristics. Although the association of obstructive sleep apnoea (OSA) and AF is well established, data on AF ablation efficacy in OSA are scarce. The aim of this study was to clarify the effect of OSA on the outcome of AF ablation. METHODS AND RESULTS: A series of 174 consecutive patients without polysomnography submitted to circumferential pulmonary vein ablation were included in the study. All patients were assessed by Berlin Questionnaire (BQ) and underwent an echocardiogram and a clinical evaluation. Patients with a high BQ score, indicating high risk for OSA, participated in a sleep study. Diagnoses were classified according to the apnoea-hypoapnoea index (AHI) as mild (AHI < 10/h), non-severe (AHI < 30/h), or severe (AHI >or= 30/h) OSA. Follow-up consisted of outpatient visits and 24 or 48 h Holter monitoring at 1, 4, and 7 months, and every 6 months thereafter. Any episode of AF or left atrial (LA) flutter was considered recurrence. Fifty-one (29.3%) patients had high BQ scores. The sleep study showed that 17 (9.8%) and 25 (14.4%) of these patients had non-severe and severe OSA, respectively. One-year arrhythmia-free probability after a single ablation procedure was 48.5% in patients with low risk for OSA (low BQ score or AHI < 10/h), 30.4% in the non-severe OSA group (10 < AHI < 30/h) and 14.3% in the severe OSA group (AHI >or= 30). Anteroposterior LA diameter [hazard ratio (HR) = 1.046, 95% confidence interval (CI): 1.005-1.089; P = 0.029] and severe OSA (HR = 1.870, 95% CI: 1.106-3.161; P = 0.019) were the independent predictors of arrhythmia recurrence. CONCLUSION: In patients with AF ablation, the presence of severe OSA is an independent predictor for AF ablation failure. SN - 1532-2092 UR - https://www.unboundmedicine.com/medline/citation/20488856/Low_efficacy_of_atrial_fibrillation_ablation_in_severe_obstructive_sleep_apnoea_patients_ L2 - https://academic.oup.com/europace/article-lookup/doi/10.1093/europace/euq128 DB - PRIME DP - Unbound Medicine ER -