Apnea–hypopnea index as a predictor of atrial fibrillation recurrence following initial pulmonary vein isolation: usefulness of type-3 portable monitor for sleep-disordered breathing

• DOI: 10.1007/s10840-016-0148-z
• Publication Date: 2016-06-08T00:41:02Z
• Authors: Hiroshi Kawakami; Takayuki Nagai; Akira Fujii; Teruyoshi Uetani; Kazuhisa Nishimura; Katsuji Inoue; Jun Suzuki; Yasunori Oka; Takafumi Okura; Jitsuo Higaki; Akiyoshi Ogimoto; Shuntaro Ikeda
• Keywords: Male; Polysomnography; Reproducibility of Results; Middle Aged; Sensitivity and Specificity; Severity of Illness Index; Disease-Free Survival; 03 medical and health sciences; Sleep Apnea Syndromes; Treatment Outcome; 0302 clinical medicine; Heart Conduction System; Pulmonary Veins; Recurrence; Atrial Fibrillation; Outcome Assessment, Health Care; Humans; Female; Retrospective Studies

The relationship between atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) and sleep-disordered breathing (SDB) evaluated using type-3 portable monitoring (PM) is still unknown. We investigated high-risk patients with AF recurrence after initial PVI using the apnea-hypopnea index (AHI) measured by type-3 PM.One hundred twenty-four (85 males; age 62 ± 10 years) AF patients undergoing initial PVI were enrolled: 83, paroxysmal AF; 41, persistent AF. At baseline, all patients were subjected to in-hospital unattended overnight polygraphy using type-3 PM for SDB.During 13 ± 7 months following initial PVI, 47 patients (38 %) experienced AF recurrence. AHI and left atrial volume index (LAVI) were significantly greater in patients with than in those without AF recurrence (AHI P = 0.011; LAVI P < 0.001). LAVI was an independent predictor of AF recurrence following initial PVI in patients with both paroxysmal AF and persistent AF (paroxysmal AF P = 0.008; persistent AF P = 0.002). However, AHI was an independent predictor of AF recurrence following initial PVI in patients with paroxysmal AF (P = 0.034) but not in those with persistent AF. The optimal cutoff value was defined as AHI = 14.1. AF recurrence following PVI is three times higher in patients with AHI ≥14.1 than in patients with AHI < 14.1.AHI measured using type-3 PM is a useful predictor of outcome following initial PVI in patients with paroxysmal AF.