Maan Abhishek, Mansour Moussa, Anter Elad, Patel Vickas V, Cheng Alan, Refaat Marwan M, Ruskin Jeremy N, Heist E Kevin
From the *Division of Electrophysiology, Massachusetts General Hospital, Boston, MA; †Harvard Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Boston, MA; ‡Department of Physiology, Cardiovascular Research Center, Section of Clinical Cardiac Electrophysiology, Temple University School of Medicine, Philadelphia, PA; §Division of Electrophysiology, Johns Hopkins University, Baltimore, MD.
Crit Pathw Cardiol. 2015 Jun;14(2):81-5. doi: 10.1097/HPC.0000000000000044.
Obstructive sleep apnea (OSA) is increasingly recognized as an important risk factor for arrhythmogenesis. Epidemiological and clinical studies have suggested a strong association between OSA and atrial fibrillation (AF). With the increasing global epidemic of obesity, the incidence of OSA is also expected to rise. Various mechanisms mediated through adverse electrical and structural changes have been proposed to explain the increased risk of AF in patients with OSA. Multiple studies have also observed a greater risk of AF recurrence after cardioversion and catheter ablation (CA) in the patients with untreated OSA. The epidemiological and pathophysiological associations between OSA and AF have significant implications on the treatment outcomes of rhythm-control strategies for AF. Adequate screening and optimal management of OSA are of key importance to help improve the clinical outcomes following cardioversion and CA. In this review, we sought to describe the role of various mechanisms by which OSA mediates the pathogenesis of AF and contributes to adverse outcomes following CA.
阻塞性睡眠呼吸暂停（OSA）越来越被认为是心律失常发生的重要危险因素。流行病学和临床研究表明OSA与心房颤动（AF）之间存在密切关联。随着全球肥胖症的流行，OSA的发病率预计也会上升。已提出多种通过不良电学和结构变化介导的机制来解释OSA患者发生AF风险增加的原因。多项研究还观察到，未经治疗的OSA患者在心脏复律和导管消融（CA）后发生AF复发的风险更高。OSA与AF之间的流行病学和病理生理关联对AF节律控制策略的治疗结果具有重要意义。对OSA进行充分筛查和优化管理对于改善心脏复律和CA后的临床结果至关重要。在本综述中，我们试图描述OSA介导AF发病机制并导致CA后不良结局的各种机制所起的作用。
