Effect of Continuous Positive Airway Pressure on Arrhythmia in Atrial Fibrillation and Sleep Apnea: A Randomized Controlled Trial

• DOI: 10.1164/rccm.202011-4133oc
• Publication Date: 2021-05-03T15:38:36Z
• Authors: Gunn Marit Traaen; Lars Aakerøy; Tove-Elizabeth Hunt; Britt Øverland; Christina Bendz; Lars Øivind Sande; Svend Aakhus; Morten Wang Fager...; Sigurd Steinshamn; Ole-Gunnar Anfinsen; Richard John Massey; Kaspar Broch; Thor Ueland; Harriet Akre; Jan Pål Loennechen; Lars Gullestad
• Keywords: Male; Sleep Apnea, Obstructive; Continuous Positive Airway Pressure; Norway; Middle Aged; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Atrial Fibrillation; Outcome Assessment, Health Care; Prevalence; Humans; Female; Aged

Rationale: Sleep apnea (SA) is highly prevalent in patients with atrial fibrillation (AF), and both conditions are associated adverse cardiovascular outcomes.Objectives: To determine the effect of continuous positive airway pressure (CPAP) on AF burden.Methods: This open-label, parallel-group, randomized controlled trial included paroxysmal moderate to severe SA (apnea-hypopnea index ⩾15). A computerized system eligible (1:1) 5 months' treatment CPAP plus usual care (CPAP, n = 55) or alone (control, 54). The outcome assessment was blinded. planned primary difference between control groups change burden (percentage time AF) as measured by implantable loop recorder.Measurements Main Results: total 579 had respiratory polygraphy, whom 244 (42%) SA. Of these, 158 (65%) participated run-in period, 39 (25%) did not tolerate treatment. 108 were available for analysis. mean decreased from 5.6% at baseline 4.1% during last 3 months intervention 5.0% 4.3% group. adjusted between-group follow-up -0.63 (95% confidence interval, -2.55 1.30) percentage points (P 0.52). Seven serious events (13%) occurred group, two (4%) group.Conclusions: In SA, result a statistically significant reduction AF.Clinical registered www.clinicaltrials.gov (NCT02727192).