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Published in: Clinical Research in Cardiology 2/2018

01-02-2018 | Original Paper

Characteristics of sleep-disordered breathing in patients with atrial fibrillation and preserved left ventricular ejection fraction

Authors: Johanna Strotmann, Henrik Fox, Thomas Bitter, Odile Sauzet, Dieter Horstkotte, Olaf Oldenburg

Published in: Clinical Research in Cardiology | Issue 2/2018

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Abstract

Background

Sleep-disordered breathing (SDB) represents a common and highly relevant co-morbidity in patients with atrial fibrillation (Afib). Obstructive sleep apnea (OSA) has been identified as an independent risk factor for developing Afib and for Afib recurrence after treatment, but the role of central sleep apnea (CSA) is less clear. This study investigated characteristics of SDB in Afib patients with preserved left ventricular ejection fraction (PEF).

Methods and results

Consecutive patients (07/2007 to 03/2016) with documented Afib at hospital admission and PEF undergoing 6-channel cardiorespiratory polygraphy (PG) screening were retrospectively analyzed. A total of 211 patients were included (146 men; age 68.7 ± 8.5 years). Only 6.6% of patients had no SDB (apnea-hypopnea index [AHI] < 5/h). When moderate-to-severe SDB (AHI ≥ 15/h) was classified based on the predominant type of apneas and hypopneas, OSA (≥ 80% obstructive events) was found in 15% of patients, CSA (≥ 80% central events) in 10%, and 36% had mixed sleep apnea. For patients with Cheyne–Stokes respiration (CSR; 34%), time spent in CSR increased significantly as total AHI increased (p < 0.001); total CSR duration was 20, 50, and 117 min, respectively, in patients with mild, moderate, and severe SDB.

Conclusions

SDB was highly prevalent in this cohort of patients with Afib and PEF. The proportion of patients with moderate-to-severe OSA, for whom treatment is recommended by current guidelines, was about 15%. With 36% of patients presenting with moderate-to-severe mixed sleep apnea and almost 10% of patients having CSA, treatment guidelines for these types of SDB in the setting of Afib are needed.
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Metadata
Title
Characteristics of sleep-disordered breathing in patients with atrial fibrillation and preserved left ventricular ejection fraction
Authors
Johanna Strotmann
Henrik Fox
Thomas Bitter
Odile Sauzet
Dieter Horstkotte
Olaf Oldenburg
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Research in Cardiology / Issue 2/2018
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-017-1163-5

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