Atrial fibrillation and sleep-disordered breathing.
Identifieur interne : 003128 ( Main/Exploration ); précédent : 003127; suivant : 003129Atrial fibrillation and sleep-disordered breathing.
Auteurs : Florent Lavergne [Allemagne] ; Laurent Morin [Allemagne] ; Jeff Armitstead [Allemagne] ; Adam Benjafield [Allemagne] ; Glenn Richards [Allemagne] ; Holger Woehrle [Allemagne]Source :
- Journal of thoracic disease [ 2072-1439 ] ; 2015.
Abstract
Atrial fibrillation (AF) is a common supraventricular arrhythmia that increases in prevalence with increasing age and in the presence of comorbidities such as heart failure (HF). AF increases the risk of a number of serious complications, including stroke and HF. As a result, the rate of hospitalization is high, making AF a costly disease. Treatment strategies for AF are broadly based around rate and rhythm control, either pharmacological or mechanical. There appear to be a number of links between sleep-disordered breathing (SDB) and AF, although further studies are needed to fully understand the physiological mechanisms that link these conditions. Patients with AF and SDB share a number of risk factors and comorbidities, including age, male sex, hypertension, congestive HF and coronary artery disease (CAD), and the prevalence of SDB in AF is higher than in the general population. Prevalence rates of obstructive sleep apnea (OSA) in patients with AF have been reported to range from 21% to just over 80%. The prevalence of central sleep apnea (CSA) in patients with AF is less well defined, but appears to be particularly high in patients who also have HF and a reduced left ventricular ejection fraction (LVEF). The frequency of apneas can be reduced by effective treatment of AF, while co-existing OSA reduces the effectiveness of treatments for AF and there is an increased risk of arrhythmia recurrence in the presence of SDB. Treating OSA with continuous positive airway pressure (CPAP) therapy has shown the potential to decrease the incidence of AF, improve the effectiveness of AF interventions, and decrease the risk of arrhythmia recurrence, although data from large randomized, controlled clinical trials are lacking. Based on available data, inclusion of SDB recognition and management strategies as part of AF management appears to have the potential to reduce the impact of this arrhythmia at both the individual and societal levels, and has been recognized as important in recent guidelines.
DOI: 10.3978/j.issn.2072-1439.2015.12.57
PubMed: 26793367
Affiliations:
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5 Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Ulm, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>1 ResMed Science Center, Lyon, France ; 2 ResMed Science Center, Sydney, Australia ; 3 ResMed Science Center, San Diego, USA ; 4 ResMed Science Center, Martinsried, Germany ; 5 Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Ulm</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Ulm</settlement></placeName></affiliation></author><author><name sortKey="Richards, Glenn" sort="Richards, Glenn" uniqKey="Richards G" first="Glenn" last="Richards">Glenn Richards</name><affiliation wicri:level="3"><nlm:affiliation>1 ResMed Science Center, Lyon, France ; 2 ResMed Science Center, Sydney, Australia ; 3 ResMed Science Center, San Diego, USA ; 4 ResMed Science Center, Martinsried, Germany ; 5 Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Ulm, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>1 ResMed Science Center, Lyon, France ; 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3 ResMed Science Center, San Diego, USA ; 4 ResMed Science Center, Martinsried, Germany ; 5 Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Ulm</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Ulm</settlement></placeName></affiliation></author></analytic><series><title level="j">Journal of thoracic disease</title><idno type="ISSN">2072-1439</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Atrial fibrillation (AF) is a common supraventricular arrhythmia that increases in prevalence with increasing age and in the presence of comorbidities such as heart failure (HF). AF increases the risk of a number of serious complications, including stroke and HF. As a result, the rate of hospitalization is high, making AF a costly disease. Treatment strategies for AF are broadly based around rate and rhythm control, either pharmacological or mechanical. There appear to be a number of links between sleep-disordered breathing (SDB) and AF, although further studies are needed to fully understand the physiological mechanisms that link these conditions. Patients with AF and SDB share a number of risk factors and comorbidities, including age, male sex, hypertension, congestive HF and coronary artery disease (CAD), and the prevalence of SDB in AF is higher than in the general population. Prevalence rates of obstructive sleep apnea (OSA) in patients with AF have been reported to range from 21% to just over 80%. The prevalence of central sleep apnea (CSA) in patients with AF is less well defined, but appears to be particularly high in patients who also have HF and a reduced left ventricular ejection fraction (LVEF). The frequency of apneas can be reduced by effective treatment of AF, while co-existing OSA reduces the effectiveness of treatments for AF and there is an increased risk of arrhythmia recurrence in the presence of SDB. Treating OSA with continuous positive airway pressure (CPAP) therapy has shown the potential to decrease the incidence of AF, improve the effectiveness of AF interventions, and decrease the risk of arrhythmia recurrence, although data from large randomized, controlled clinical trials are lacking. Based on available data, inclusion of SDB recognition and management strategies as part of AF management appears to have the potential to reduce the impact of this arrhythmia at both the individual and societal levels, and has been recognized as important in recent guidelines.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Bade-Wurtemberg</li><li>District de Tübingen</li></region><settlement><li>Ulm</li></settlement></list><tree><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Lavergne, Florent" sort="Lavergne, Florent" uniqKey="Lavergne F" first="Florent" last="Lavergne">Florent Lavergne</name></region><name sortKey="Armitstead, Jeff" sort="Armitstead, Jeff" uniqKey="Armitstead J" first="Jeff" last="Armitstead">Jeff Armitstead</name><name sortKey="Benjafield, Adam" sort="Benjafield, Adam" uniqKey="Benjafield A" first="Adam" last="Benjafield">Adam Benjafield</name><name sortKey="Morin, Laurent" sort="Morin, Laurent" uniqKey="Morin L" first="Laurent" last="Morin">Laurent Morin</name><name sortKey="Richards, Glenn" sort="Richards, Glenn" uniqKey="Richards G" first="Glenn" last="Richards">Glenn Richards</name><name sortKey="Woehrle, Holger" sort="Woehrle, Holger" uniqKey="Woehrle H" first="Holger" last="Woehrle">Holger Woehrle</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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