Atrial fibrillation among patients under investigation for suspected obstructive sleep apnea.
OBJECTIVE
Obstructive sleep apnea is common among patients with atrial fibrillation, but the prevalence and risk factors for atrial fibrillation among patients who are being investigated on suspicion of sleep apnea are not well known. The aim of the study was to estimate the prevalence of atrial fibrillation among patients investigated for suspected obstructive sleep apnea and to identify risk factors for atrial fibrillation among them.


METHODS
The prevalence of atrial fibrillation was investigated among 201 patients referred for suspected obstructive sleep apnea. Patients without known atrial fibrillation were investigated with a standard 12-lead ECG at hospital and short intermittent handheld ECG recordings at home, during 14 days.


RESULTS
Atrial fibrillation occurred in 13 of 201 subjects (6.5%), and in 12 of 61 men aged 60 years and older (20%). The prevalence of atrial fibrillation increased with sleep apnea severity (p = 0.038). All patients with atrial fibrillation were men and all had sleep apnea. Age 60 or older, the occurrence of central sleep apnea and diabetes mellitus were independent risk factors for atrial fibrillation after adjustments for body mass index, gender, sleep apnea and cardiovascular disease.


CONCLUSIONS
Atrial fibrillation is common among subjects referred for sleep apnea investigation and the prevalence of atrial fibrillation increases with sleep apnea severity. Independent risk factors for atrial fibrillation among patients investigated for suspected obstructive sleep apnea include the occurrence of coexisting central sleep apnea, age 60 years or older and diabetes mellitus.
Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
Tijn
http://orcid.org/0000-0001-7159-4043
T
Hendrikx
Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Martin
M
Sundqvist
Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
Herbert
H
Sandström
Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
Carin
C
Sahlin
Clinical Sciences, Danderyd Hospital, Karolinska Institute and Nordic Heart Center, Stockholm, Sweden.
Morteza
M
Rohani
Clinical Sciences, Danderyd Hospital, Karolinska Institutet, and Stockholm Heart Center, Stockholm, Sweden.
Faris
F
Al-Khalili
Surgical and Perioperative Sciences, Clinical Physiology, Umeå University, Umeå, Sweden.
Rolf
R
Hörnsten
Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
Anders
A
Blomberg
Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
Per
P
Wester
Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Mårten
M
Rosenqvist
Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.
Karl A
KA
Franklin
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D063868:Patient Outcome Assessment; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology