0873 Impact of Obstructive Sleep Apnea Treatment on Mortality in Atrial Fibrillation Patients

Abstract Introduction The intricate relationship between atrial fibrillation (AF) and obstructive sleep apnea (OSA) has garnered attention due to its potential impact on morbidity and mortality. This study explores the characteristics of individuals with both AF and OSA, aiming to shed light on associated outcomes. 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, oxygen desaturation index (ODI), ablation, cardioversion rates, and electrophysiology (EP) clinic follow-ups. Results Among 29,000 patient encounters, 2,971 unique patients met inclusion criteria. 64% were male, with a mean age of 74.9 for deceased patients versus 68.1 for the alive cohort (p 0.001). Deceased patients had a higher mean BMI (35.8 vs. 34.3, p = 0.003) and AHI (27 vs. 25, p = 0.0143). Oxygen desaturation was observed in 34% of deceased patients compared to 28% in the alive cohort (p 0.0001). Ablation and cardioversion did not significantly impact mortality. The all-cause mortality rate was 12.7%. Conclusion Analysis revealed that prolonged hypoxia increased mortality risk in AF and OSA patients. Although higher AHI was noted in deceased patients, its clinical significance was limited. We also found that ablation and cardioversion did not improve mortality. Effective OSA treatment in AF patients can potentially improve outcomes. Further studies are necessary to determine if reducing oxygen burden reduces mortality in this population. Support (if any) A study published in the American Journal of Respiratory and Critical Care Medicine found that CPAP therapy reduced the incidence of AF-related mortality. The data from over 10,000 patients, demonstrated that those receiving effective sleep apnea interventions, such as CPAP, exhibited a 35% reduction in all-cause mortality compared to untreated counterparts. This research highlights the potential life-saving benefits of addressing sleep-disordered breathing in the management of AF.