Key result
Obstructive sleep apnoea increased AF recurrence risk after catheter ablation (RR 1.31, P=0.00), but CPAP therapy mitigated this risk to levels similar to patients without OSA (RR 1.25, P=0.37).
Why the study?
Does CPAP therapy reduce atrial fibrillation recurrence after catheter ablation in patients with obstructive sleep apnoea?
Meta-Analysis (n=3,743)
Does CPAP therapy reduce atrial fibrillation recurrence after catheter ablation in patients with obstructive sleep apnoea?
CPAP therapy in patients with obstructive sleep apnoea undergoing AF catheter ablation reduces the risk of AF recurrence to levels similar to patients without OSA.
Answers are grounded in this paper and cite their sources.
Supports CPAP in OSA patients undergoing AF ablation; confirms recurrence risk normalization to non-OSA levels.
AIMS: An association between obstructive sleep apnoea (OSA) and atrial fibrillation (AF) has been established. However, studies on the role of OSA in AF recurrence after catheter ablation have yielded conflicting results, and the effect of OSA treatment by continuous positive airway pressure (CPAP) on the success rate of AF catheter ablation is indeterminate. The aim of this meta-analysis was to investigate the rate of AF recurrence after catheter ablation in patients with AF with or without OSA and to evaluate the relationship between CPAP therapy and AF recurrence. METHODS AND RESULTS: We performed an online search and identified five studies involving 3743 patients with AF. Patients with OSA had a 31% greater risk of AF recurrence after catheter ablation than did patients without OSA [relative ratio (RR) = 1.31, P = 0.00], and this risk increased by 57% in patients with OSA not undergoing CPAP therapy (RR = 1.57, P = 0.00). However, CPAP users had a risk of AF recurrence similar to that of patients without OSA (RR = 1.25, P = 0.37), and this similarity was maintained even after the removal of study heterogeneity (RR = 0.99, P = 0.39). CONCLUSION: Obstructive sleep apnoea was associated with AF recurrence after catheter ablation. The efficacy of catheter ablation for AF was similar between patients without OSA and patients with OSA undergoing CPAP treatment.
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Li et al. (2014) conducted a meta-analysis in Atrial fibrillation and obstructive sleep apnoea (n=3,743). Obstructive sleep apnoea with or without CPAP vs. No obstructive sleep apnoea was evaluated on Atrial fibrillation recurrence after catheter ablation (RR 1.31, p=0.00). Obstructive sleep apnoea increased AF recurrence risk after catheter ablation (RR 1.31, P=0.00), but CPAP therapy mitigated this risk to levels similar to patients without OSA (RR 1.25, P=0.37).
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