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持续气道正压通气治疗对阻塞性睡眠呼吸暂停患者心房颤动复发的影响:一项系统评价和荟萃分析

[Continuous positive airway pressure therapy affects the recurrence of atrial fibrillation in patients with obstructive sleep apnea: a systematic review and meta-analysis].

作者信息

Wang Y X, Luo J M, Huang R, Xiao Y

机构信息

Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2023 Aug 12;46(8):751-759. doi: 10.3760/cma.j.cn112147-20230213-00064.

Abstract

A higher incidence of atrial fibrillation is associated with obstructive sleep apnea. The effects of continuous positive airway pressure on atrial fibrillation have been studied in observational studies and randomized controlled trials. We therefore conducted this meta-analysis to assess the effect of continuous positive airway pressure on the recurrence of atrial fibrillation after radiofrequency ablation. A comprehensive search was conducted in Pubmed, Embase, Cochrane, Web of Science, Wanfang Data and CNKI databases from inception to October 2022. We included cohort studies and randomized controlled trials containing atrial fibrillation situation after catheter ablation with and without continuous positive airway pressure therapy. The random effects model was used to assess odds ratios () and confidence intervals (). was used to assess the heterogeneity. Eight studies with a total of 1 395 patients with obstructive sleep apnea met the inclusion criteria. Continuous positive airway pressure therapy decreased atrial fibrillation recurrence by 61% (=0.392, 95%: 0.267-0.576, =37.6%). Subgroup analysis showed that the protective effect was more significant in groups with more hypertension patients (0.272 . 0.550, 95%: 0.165-0.449 . 0.329-0.922). Continuous positive airway pressure therapy reduces the recurrence rate of atrial fibrillation. Patients with hypertension are more likely to benefit from it.

摘要

心房颤动的发生率较高与阻塞性睡眠呼吸暂停有关。在观察性研究和随机对照试验中,已经对持续气道正压通气对心房颤动的影响进行了研究。因此,我们进行了这项荟萃分析,以评估持续气道正压通气对射频消融术后心房颤动复发的影响。从数据库建立至2022年10月,我们在PubMed、Embase、Cochrane、Web of Science、万方数据和中国知网数据库中进行了全面检索。我们纳入了包含有或无持续气道正压通气治疗的导管消融术后心房颤动情况的队列研究和随机对照试验。采用随机效应模型评估比值比(OR)和置信区间(CI)。I²用于评估异质性。八项研究共纳入1395例阻塞性睡眠呼吸暂停患者,符合纳入标准。持续气道正压通气治疗使心房颤动复发率降低了61%(OR=0.392,95%CI:0.267-0.576,I²=37.6%)。亚组分析显示,在高血压患者较多的组中,保护作用更为显著(0.272,I²=0.550,95%CI:0.165-0.449,I²=0.329-0.922)。持续气道正压通气治疗可降低心房颤动的复发率。高血压患者更可能从中受益。

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