Obstructive Sleep Apnea Is Closely Related to Cardiovascular Risk Factors, but Not to Clinical Recurrence of Atrial Fibrillation after Catheter Ablation: An Analysis of Atrial Fibrillation Patients

BACKGROUND: Obstructive sleep apnea (OSA) is a well-known predictor of atrial fibrillation (AF). However, OSA usually accompanies other risk factors of AF. We tried to investigate whether OSA is related to AF recurrence after catheter ablation. METHODS: A total of 378 patients (mean age 59.9 ± 10.7 years, 72.5$ male) who underwent catheter ablation of AF were enrolled and underwent overnight ambulatory polysomnography before the ablation procedure. These patients were examined once every 3 months at the outpatient clinic to determine AF recurrence. RESULTS: Based on the apnea-hypopnea index (AHI), we divided the study subjects into 3 groups defined as mild (AHI < 10), moderate (10 30) OSA. Patients with severe OSA had a higher prevalence of hypertension, diabetes mellitus, and coronary artery disease (CAD). However, AF recurrence was not different between the three groups. The Kaplan-Meier analysis also showed no significant difference in AF recurrence according to the degree of severity of OSA. Multivariate logistic regression analysis revealed that OSA might be a predictor of CAD; however, Cox regression analysis showed that only early recurrence is closely related to AF recurrence after catheter ablation, rather than the severity of OSA. CONCLUSION: This study shows that the severity of OSA is not associated with the recurrence of AF after catheter ablation in Korean patients. Treatment of OSA for the sole indication of lowering AF recurrence may need to be reconsidered.