0875 The Impact of Non-compliance with CPAP Therapy on Mortality in Atrial Fibrillation Patients

Abstract Introduction Atrial Fibrillation (AF) patients commonly experience comorbidities such as sleep apnea, emphasizing the need for effective management strategies. This study investigates the association between non-compliance with Continuous Positive Airway Pressure (CPAP) therapy and increased mortality in AF patients. Methods Utilizing data from the Geisinger Health System (2007-2023), we focused on cardiology patients with AF. Inclusion criteria comprised age 18, AF and OSA diagnosis, and polysomnography with an apnea-hypopnea index (AHI) 5. Data collected included age, gender, body mass index (BMI), mean AHI, adherence within 1st three months of starting CPAP therapy, Medicare adherence percentage, and CAI. Results Among 29,000 patient encounters, 2,971 unique patients met inclusion criteria. We chart reviewed 100 patients by looking at compliance reports within the first three months of CPAP use. Mean adherence time within the first three months was 5 hours 39 minutes for the alive cohort vs 4 hours 9 minutes for the patients that died (p=0.02). Mean Medicare medical adherence percentage for alive cohort was 73% vs 71% for the patients that died (p=0.361). Deceased patients had higher association of having AHI 5 (p=0.016). Mean CAI for the alive cohort was 0.81 vs 0.62 for the deceased cohort (p=0.912). All-cause mortality rate was 12.7%. Conclusion Our findings underscore the critical impact of CPAP compliance on mortality outcomes in AF patients. Non-compliance with CPAP therapy within the first three months of use and AHI 5 emerged as a significant predictor of increased mortality, emphasizing the need for targeted interventions to enhance adherence in this population. The implications of our study extend beyond mortality, encompassing broader cardiovascular outcomes and healthcare utilization. Studies have established the relationship between AF and sleep apnea. Sleep apnea, prevalent in up to 50% of AF patients, exacerbates the arrhythmia's progression and increases the risk of cardiovascular events. While CPAP therapy has demonstrated efficacy in ameliorating the cardiovascular impact of sleep apnea, limited research has explored its effect on mortality in AF patients. Studies examining CPAP therapy's impact on AF outcomes have primarily focused on surrogate markers such as AF recurrence and symptom severity. Support (if any)