Atrial fibrillation (AF) is
the most common cardiac arrhythmia and shares many of the same risk factors as
another common clinical condition, sleep apnea. The estimated prevalence of sleep
apnea has increased over the past decade, and reflects a parallel increase in
the most prominent risk factors of obesity and overweight. Both obstructive and central sleep apnea have
been associated with AF in multiple studies, with the risk of AF increasing 2-4-fold
compared to those without sleep disordered breathing. Continuous positive
airway pressure (CPAP) has been shown to reduce the rate of AF recurrence
following cardioversion and radiofrequency ablation in patients with sleep
apnea. However, the mechanisms by which
sleep apnea precipitates AF or vice versa, remain unclear. In this Review, we examine the studies
linking AF and sleep apnea, discuss the existing data supporting a mechanistic
link between the two conditions, present the existing evidence for the
effectiveness of CPAP in this growing population, and suggest possible
approaches to screen AF patients for sleep disordered breathing.
Credits: Patricia Tung; Elad Anter