Scholarlink

Background <p>Obstructive sleep apnea (OSA) is associated with an increased risk of atrial fibrillation (AF). However, the impact of continuous positive airway pressure (CPAP) on the recurrence of AF after catheter ablation (CA) in patients with OSA remains unclear.</p> Methods <p>We systematically searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) and observational studies comparing CPAP vs. no CPAP use for OSA treatment and recurrence of AF following CA. Heterogeneity was assessed with <i>I</i><sup>2</sup> statistics.</p> Results <p>We included 1 RCT and 10 observational studies with 1536 patients with OSA who underwent CA for AF, of whom 53% used CPAP. Mean follow-up ranged from 3 to 42&#xa0;months. In the pooled analysis, AF recurrence (OR 0.37; 95% CI 0.23–0.58; <i>p</i> &lt; 0.01) was significantly lower in patients treated with CPAP compared with no CPAP. In the subgroup analysis, the AF recurrence in the CPAP group was also significantly lower after restricting to studies with longer follow-up periods ≥ 18&#xa0;months (OR 0.28; 95% CI 0.18–0.46; <i>p</i> &lt; 0.01) and in studies with a greater proportion of persistent AF (≥ 50%) (OR 0.31; 95% CI 0.16–0.61; <i>p</i> &lt; 0.01).</p> Conclusion <p>In patients with OSA and AF who underwent CA, CPAP use was associated with reduced AF recurrence compared to no CPAP use. Most of the data available is derived from observational studies, and the only RCT showed no difference between groups. Thus, results should be interpreted with caution.</p> Graphical Abstract <p><b>Central Illustration:</b> Efficacy of CPAP on AF Recurrence after Catheter Ablation in Patients with Obstructive Sleep Apnea. AF = atrial fibrillation; CI = confidence interval; CPAP = continuous positive airway pressure; OSA = obstructive sleep apnea; RCT = randomized controlled trial.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Efficacy of continuous positive airway pressure on atrial fibrillation recurrence after catheter ablation in patients with obstructive sleep apnea: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年6月13日

查看全文
  • Eduardo Dan Itaya,
  • Caique M. P. Ternes,
  • Timothy Maher,
  • Amanda A. D. Fernandes,
  • Ana Vitoria Rocha,
  • Catherine Wippel,
  • André Rivera,
  • Andrew H. Locke,
  • Andre d’Avila

摘要

Background

Obstructive sleep apnea (OSA) is associated with an increased risk of atrial fibrillation (AF). However, the impact of continuous positive airway pressure (CPAP) on the recurrence of AF after catheter ablation (CA) in patients with OSA remains unclear.

Methods

We systematically searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) and observational studies comparing CPAP vs. no CPAP use for OSA treatment and recurrence of AF following CA. Heterogeneity was assessed with I2 statistics.

Results

We included 1 RCT and 10 observational studies with 1536 patients with OSA who underwent CA for AF, of whom 53% used CPAP. Mean follow-up ranged from 3 to 42 months. In the pooled analysis, AF recurrence (OR 0.37; 95% CI 0.23–0.58; p < 0.01) was significantly lower in patients treated with CPAP compared with no CPAP. In the subgroup analysis, the AF recurrence in the CPAP group was also significantly lower after restricting to studies with longer follow-up periods ≥ 18 months (OR 0.28; 95% CI 0.18–0.46; p < 0.01) and in studies with a greater proportion of persistent AF (≥ 50%) (OR 0.31; 95% CI 0.16–0.61; p < 0.01).

Conclusion

In patients with OSA and AF who underwent CA, CPAP use was associated with reduced AF recurrence compared to no CPAP use. Most of the data available is derived from observational studies, and the only RCT showed no difference between groups. Thus, results should be interpreted with caution.

Graphical Abstract

Central Illustration: Efficacy of CPAP on AF Recurrence after Catheter Ablation in Patients with Obstructive Sleep Apnea. AF = atrial fibrillation; CI = confidence interval; CPAP = continuous positive airway pressure; OSA = obstructive sleep apnea; RCT = randomized controlled trial.