Department of Cardiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
Nat Sci Sleep. 2010 Apr 15;2:39-45. doi: 10.2147/nss.s7625. Print 2010.
Atrial fibrillation (AF) is the most common sustained arrhythmia. The clinical impact of AF results primarily from its association with stroke, heart failure, and increased overall mortality. Recently there has been increasing evidence of an important association between obstructive sleep apnea (OSA) and AF. OSA is a common breathing disorder affecting an estimated 5% of the population and is highly prevalent in patients with established cardiovascular disease. The prevalence of OSA among patients with AF is remarkable with estimates ranging from 32%-49%. The pathophysiological connection between AF and OSA remains speculative, but appears to be the result of apnea-induced hypoxia, intrathoracic pressure shifts, inflammation, heightened sympathetic activity, and autonomic instability leading to hypertension, diastolic dysfunction, left atrial enlargement, and electrical remodeling. Initial results appear promising that intervention with continuous positive airway pressure may be effective in reducing the burden of AF in this population, however, further investigations are needed. Here, we review the literature on the current epidemiologic data, pathophysiology, and therapeutics linking these two common conditions.
心房颤动（AF）是最常见的持续性心律失常。AF 的临床影响主要源于其与中风、心力衰竭和总死亡率增加的关联。最近越来越多的证据表明阻塞性睡眠呼吸暂停（OSA）与 AF 之间存在重要关联。OSA 是一种常见的呼吸障碍，估计影响 5%的人口，在已确诊心血管疾病的患者中患病率很高。在 AF 患者中，OSA 的患病率非常显著，估计范围为 32%-49%。AF 和 OSA 之间的病理生理联系仍在推测之中，但似乎是由于呼吸暂停引起的缺氧、胸腔内压力变化、炎症、交感神经活动增强以及自主神经不稳定导致高血压、舒张功能障碍、左心房扩大和电重构。初步结果表明，持续气道正压通气干预可能对降低该人群 AF 的负担有效，但是需要进一步的研究。在这里，我们回顾了关于这两种常见疾病的当前流行病学数据、病理生理学和治疗学的文献。
