The association between obstructive sleep apnea (OSA) and atrial fibrillation (AF)
is strong and is now well established. However, studies on the role of OSA on AF recurrence
after catheter ablation have yielded conflicting results. The aim of the present study
was to investigate the role of OSA on AF recurrence after catheter-based pulmonary
vein isolation. We performed a data search on the PubMed, Web of Science, and the
Cochrane databases for studies published by August 2010. In addition, we manually
searched the conference proceedings of the European Society of Cardiology, American
College of Cardiology, and American Heart Association for related abstracts. After
the initial search returned 402 reports, we identified 6 studies with a total of 3,995
patients that met our inclusion criteria. Overall, patients with OSA have a 25% greater
risk of AF recurrence after catheter ablation than those without OSA (risk ratio 1.25,
95% confidence interval 1.08 to 1.45, p = 0.003). Subgroup analysis showed that OSA
diagnosed using polysomnography is a strong predictor of AF recurrence (risk ratio
1.40, 95% confidence interval 1.16 to 1.68, p = 0.0004) but not when OSA was diagnosed
using the Berlin questionnaire (risk ratio 1.07, 95% confidence interval 0.91 to 1.27,
p = 0.39). In conclusion, patients with OSA have significantly greater AF recurrence
rates after pulmonary vein isolation. In addition to other factors, a diagnosis of
OSA merits special consideration when evaluating patients for catheter-based AF ablation.
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Article info
Publication history
Published online: May 02, 2011
Accepted:
February 16,
2011
Received:
December 24,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
