Division of Cardiovascular Medicine, Department of Medicine and Department of Sleep Medicine, University of Virginia, Charlottesville, VA, USA.
Department of Cardiovascular Medicine, Electrophysiology Section, Cleveland Clinic Foundation, Cleveland, OH, USA.
Sleep Med Rev. 2018 Jun;39:134-142. doi: 10.1016/j.smrv.2017.08.005. Epub 2017 Sep 4.
Sleep apnea (SA) is a common sleep disorder increasingly recognized as a risk for cardiovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. An increasing number of investigations in recent years have linked SA to AF. In this review, we aim to provide a critical overview of the existing evidence in a question and answer format by addressing the following: What is the prevalent association between the two conditions (separating nocturnally detected AF episodes from AF as a prevalent condition)? Is SA a risk factor for incident AF? Is SA a risk factor for recurrence of AF following cardioversion/catheter-based ablation? What is the association between SA and AF in patients with heart failure? Are there signature electrocardiographic markers of AF found in patients with SA? Are there electrophysiology-based studies supporting the link between SA and AF? What other sleep characteristics (beyond SA) are found in patients with AF? What is the impact of SA treatment on AF? What is the effect of AF treatment on sleep? Finally, we address unsolved questions and suggest future directions to enhance our understanding of the AF-SA relationship.
睡眠呼吸暂停（SA）是一种常见的睡眠障碍，越来越被认为是心血管疾病的危险因素。心房颤动（AF）是最常见的心律失常，与显著的发病率和死亡率相关。近年来越来越多的研究将 SA 与 AF 联系起来。在这篇综述中，我们旨在通过以下方式以问答的形式提供对现有证据的批判性概述：两种病症之间的普遍关联是什么（将夜间检测到的 AF 发作与作为普遍病症的 AF 分开）？SA 是否是 AF 事件的危险因素？SA 是否是电复律/导管消融后 AF 复发的危险因素？SA 与心力衰竭患者的 AF 有何关联？在患有 SA 的患者中是否存在 AF 的特征性心电图标记？是否有基于电生理学的研究支持 SA 和 AF 之间的联系？除了 SA 之外，还有哪些睡眠特征（除了 SA 之外）在患有 AF 的患者中发现？SA 治疗对 AF 有何影响？AF 治疗对睡眠有何影响？最后，我们解决了未解决的问题，并提出了未来的方向，以增强我们对 AF-SA 关系的理解。
