Tung Patricia, Anter Elad
Atrius Healthcare, Department of Cardiology, Boston, MA.
Harvard-Thorndike Electrophysiology Institute Cardiovascular Division, Department of Medicine Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA.
J Atr Fibrillation. 2016 Apr 30;8(6):1283. doi: 10.4022/jafib.1283. eCollection 2016 Apr-May.
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 breathing disorder. Continuous positive airway pressure (CPAP) has been shown to reduce the rate of AF recurrence following catheter 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 current date 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 approaches to screen AF patients for sleep breathing disorders.
心房颤动（AF）是最常见的心律失常，与另一种常见临床病症——睡眠呼吸暂停有许多相同的风险因素。在过去十年中，睡眠呼吸暂停的估计患病率有所上升，这反映出肥胖和超重等最主要风险因素也在同步增加。多项研究表明，阻塞性和中枢性睡眠呼吸暂停均与房颤有关，与无睡眠呼吸障碍者相比，房颤风险增加2至4倍。持续气道正压通气（CPAP）已被证明可降低睡眠呼吸暂停患者导管消融术后房颤复发率。然而，睡眠呼吸暂停引发房颤或反之的机制仍不清楚。在本综述中，我们审视了目前将房颤与睡眠呼吸暂停联系起来的数据，讨论了支持这两种病症之间存在机制联系的现有数据，介绍了CPAP在这一不断增长的人群中有效性的现有证据，并提出了筛查房颤患者睡眠呼吸障碍的方法。
