title: Obstructive Sleep Apnoea and Atrial Fibrillation.
abstract: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and is associated with significant morbidity and mortality. Obstructive sleep apnoea (OSA) is common among patients with AF. Growing evidence suggests that OSA is associated with the initiation and maintenance of AF. This association is independent of obesity, body mass index and hypertension. OSA not only promotes initiation of AF but also has a significant negative impact on the treatment of AF. Patients with untreated OSA have a higher AF recurrence rate with drug therapy, electrical cardioversion and catheter ablation. Treatment with continuous positive airway pressure (CPAP) has been shown to improve AF control in patients with OSA. In this article, we will review and discuss the pathophysiological mechanisms of OSA that may predispose OSA patients to AF as well as the standard and emerging therapies for patients with both OSA and AF.
authors.affiliation: Cardiovascular Centre, First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China;
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Cardiovascular Diseases, Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China;
authors.forename: Yuemei
authors.initials: Y
authors.lastname: Hou
authors.affiliation: Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma, US.
authors.forename: Sunny S
authors.initials: SS
authors.lastname: Po
keywords: Atrial fibrillation; apnoea–hypopnea index; autonomic nervous system; continuous positive airway pressure; obstructive sleep apnoea
references.citation: J Am Coll Cardiol. 2011 Jan 11;57(2):119-27
references.pmid: 21211682
references.citation: Arch Intern Med. 2007 Jul 23;167(14):1552-3; author reply 1553
references.pmid: 17646611
references.citation: Circulation. 2003 Mar 4;107(8):1129-34
references.pmid: 12615790
references.citation: Pacing Clin Electrophysiol. 2006 Jul;29(7):727-32
references.pmid: 16884508
references.citation: N Engl J Med. 2005 Mar 24;352(12):1206-14
references.pmid: 15788497
references.citation: Can Respir J. 2010 Sep-Oct;17(5):229-32
references.pmid: 21037998
references.citation: Sleep Med. 2012 Jun;13(6):632-6
references.pmid: 22534161
references.citation: Chest. 1994 Aug;106(2):466-71
references.pmid: 7774322
references.citation: Heart Rhythm. 2011 Dec;8(12):1933-9
references.pmid: 21767520
references.citation: Cleve Clin J Med. 2014 Aug;81(8):479-89
references.pmid: 25085986
references.citation: Hypertension. 2012 Jul;60(1):172-8
references.pmid: 22585944
references.citation: Kardiol Pol. 2014;72(8):716-24
references.pmid: 24671917
references.citation: Dtsch Arztebl Int. 2009 Mar;106(10):164-70
references.pmid: 19578392
references.citation: PLoS One. 2012;7(10):e47032
references.pmid: 23056568
references.citation: Pulm Med. 2013;2013:621736
references.pmid: 23533751
references.citation: Int J Cardiol. 2014 Jun 1;174(1):73-6
references.pmid: 24726170
references.citation: Circulation. 2004 Jul 27;110(4):364-7
references.pmid: 15249509
references.citation: Am J Cardiol. 1983 Sep 1;52(5):490-4
references.pmid: 6193700
references.citation: Am J Respir Crit Care Med. 2006 Apr 15;173(8):910-6
references.pmid: 16424443
references.citation: Hypertension. 2011 Oct;58(4):559-65
references.pmid: 21844482
references.citation: N Engl J Med. 1993 Apr 29;328(17):1230-5
references.pmid: 8464434
references.citation: Eur Heart J. 2008 Jul;29(13):1662-9
references.pmid: 18515807
references.citation: Circulation. 1998 Sep 8;98(10):946-52
references.pmid: 9737513
references.citation: Heart. 2006 Dec;92(12):1854-5
references.pmid: 17105888
references.citation: J Am Coll Cardiol. 2009 Nov 3;54(19):1797-804
references.pmid: 19874994
references.citation: J Am Coll Cardiol. 2004 Feb 4;43(3):483-90
references.pmid: 15013134
references.citation: Heart Rhythm. 2011 Sep;8(9):1436-43
references.pmid: 21457790
references.citation: J Am Coll Cardiol. 2007 Feb 6;49(5):565-71
references.pmid: 17276180
references.citation: Am J Cardiol. 2008 Dec 1;102(11):1557-61
references.pmid: 19026314
references.citation: World J Cardiol. 2013 Jun 26;5(6):157-63
references.pmid: 23802045
references.citation: Circulation. 2003 May 27;107(20):2589-94
references.pmid: 12743002
references.citation: Int J Neural Syst. 2013 Oct;23(5):1350020
references.pmid: 23924411
references.citation: Circulation. 2002 May 28;105(21):2462-4
references.pmid: 12034649
references.citation: Rev Neurol (Paris). 2002 Sep;158(8-9):785-97
references.pmid: 12386523
references.citation: J Am Heart Assoc. 2013 Nov 25;2(6):e000421
references.pmid: 24275628
references.citation: Heart Rhythm. 2013 Mar;10(3):331-7
references.pmid: 23178687
references.citation: J Clin Invest. 2014 Apr;124(4):1454-7
references.pmid: 24691480
references.citation: Thorax. 2005 Feb;60(2):174
references.pmid: 15681513
references.citation: Coron Artery Dis. 1996 Jun;7(6):475-8
references.pmid: 8889364
references.citation: JAMA. 2001 May 9;285(18):2370-5
references.pmid: 11343485
references.citation: Am J Physiol Regul Integr Comp Physiol. 2008 May;294(5):R1686-92
references.pmid: 18272662
references.citation: Heart Vessels. 2010 Jan;25(1):63-9
references.pmid: 20091401
references.citation: Circulation. 2014 Sep 9;130(11):892-901
references.pmid: 24993098
references.citation: Proc Am Thorac Soc. 2008 Feb 15;5(2):144-53
references.pmid: 18250206
references.citation: Anesthesiol Clin North Am. 2005 Sep;23(3):431-43, vi
references.pmid: 16005822
references.citation: Arch Intern Med. 2009 Jun 22;169(12):1147-55
references.pmid: 19546416
references.citation: Prog Cardiovasc Dis. 2009 Mar-Apr;51(5):411-5
references.pmid: 19249447
references.citation: Heart Rhythm. 2015 Apr;12(4):818-24
references.pmid: 25533582
references.citation: Heart Rhythm. 2010 Sep;7(9):1263-70
references.pmid: 20338265
references.citation: Heart Rhythm. 2012 Mar;9(3):321-7
references.pmid: 22016075
references.citation: Cardiovasc Res. 1974 Sep;8(5):647-55
references.pmid: 4434368
references.citation: J Am Coll Cardiol. 2006 Mar 21;47(6):1196-206
references.pmid: 16545652
references.citation: Am J Physiol Heart Circ Physiol. 2013 Dec;305(12):H1683-92
references.pmid: 24097430
references.citation: Pacing Clin Electrophysiol. 2003 Mar;26(3):669-77
references.pmid: 12698666
references.citation: J Cardiovasc Electrophysiol. 2008 Sep;19(9):997-1003
references.pmid: 18373598
references.citation: Sleep Breath. 2013 May;17(2):549-55
references.pmid: 22610662
references.citation: J Am Coll Cardiol. 2014 Nov 11;64(19):2013-23
references.pmid: 25440097
references.citation: Circulation. 1997 Oct 7;96(7):2455-61
references.pmid: 9337224
references.citation: Lancet. 2002 Jul 20;360(9328):237-45
references.pmid: 12133673
references.citation: Heart Rhythm. 2012 Sep;9(9):1409-16.e1
references.pmid: 22440155
references.citation: Hypertension. 2013 Oct;62(4):767-74
references.pmid: 23959548
references.citation: Int J Mol Sci. 2014 Oct 16;15(10):18693-705
references.pmid: 25325536
references.citation: Lancet. 2014 Feb 22;383(9918):736-47
references.pmid: 23910433
references.citation: Thorax. 2004 Jan;59(1):73-8
references.pmid: 14694254
references.citation: J Am Coll Cardiol. 2009 Nov 24;54(22):2075-83
references.pmid: 19926016
references.citation: Chest. 2004 Mar;125(3):879-85
references.pmid: 15006945
references.citation: Am J Cardiol. 2012 Aug 1;110(3):369-72
references.pmid: 22516529
references.citation: Am Heart J. 2014 Apr;167(4):620-6
references.pmid: 24655713
references.citation: Chest. 2007 Jul;132(1):325-37
references.pmid: 17625094
references.citation: J Am Coll Cardiol. 2013 Jul 23;62(4):300-5
references.pmid: 23623910
references.citation: N Engl J Med. 2014 Jun 12;370(24):2339-41
references.pmid: 24918377
references.citation: J Fam Pract. 2013 Oct;62(10):565-72
references.pmid: 24143347