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Clinical Research in Cardiology
Published in: Clinical Research in Cardiology 8/2018

01-08-2018 | Review

The why, when and how to test for obstructive sleep apnea in patients with atrial fibrillation

Authors: Lien Desteghe, Jeroen M. L. Hendriks, R. Doug McEvoy, Ching Li Chai-Coetzer, Paul Dendale, Prashanthan Sanders, Hein Heidbuchel, Dominik Linz

Published in: Clinical Research in Cardiology | Issue 8/2018

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Abstract

Sleep apnea is associated with increased cardiovascular risk and may be important in atrial fibrillation (AF) management. It is present in up to 62% of the AF population and is highly under-recognized and underdiagnosed. Obstructive sleep apnea (OSA) is strongly associated with AF and non-randomized trials have shown that its treatment can help to reduce AF recurrences and maintain sinus rhythm. The 2016 European Society of Cardiology guidelines for the management of AF recommend that AF patients should be questioned regarding the symptoms of OSA and that OSA-treatment should be optimized to improve AF treatment results. However, strategies on how to implement OSA testing in the standard work-up of AF patients are not provided in the guidelines. Additionally, overnight OSA monitoring rather than interrogation for OSA-related clinical signs alone may be necessary to reliably identify OSA in the majority of AF patients. This review summarizes the available clinical data on OSA in AF patients, and discusses the following key questions: Why and When is testing for OSA needed in AF patients? How and Where should it be performed and coordinated? and Who should test for OSA? To implement OSA testing in a cardiology or electrophysiology clinic, we propose a multidisciplinary integrated care approach based on a chronic care model. We describe the tools, infrastructure and coordination needed to test for OSA in the standard workup of patients with symptomatic AF prior to the initiation of directed invasive or pharmacological rhythm control management.
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Metadata
Title
The why, when and how to test for obstructive sleep apnea in patients with atrial fibrillation
Authors
Lien Desteghe
Jeroen M. L. Hendriks
R. Doug McEvoy
Ching Li Chai-Coetzer
Paul Dendale
Prashanthan Sanders
Hein Heidbuchel
Dominik Linz
Publication date
01-08-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Research in Cardiology / Issue 8/2018
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-018-1248-9

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