Hu Jiancheng, Zuo Siyuan, Qian Jiahui, Cheng Fangfang, Wang Dengji, Deng Yanyan, Lu Dasheng
Department of Cardiology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
Scientific Research Department, The Second Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
Front Med (Lausanne). 2025 Jan 28;12:1509776. doi: 10.3389/fmed.2025.1509776. eCollection 2025.
Obstructive sleep apnea (OSA) stands as an autonomous risk factor for a broad spectrum of cardiovascular diseases, particularly atrial fibrillation (AF), which is closely associated with heightened morbidity and mortality rates. The intricate pathophysiological pathways linking OSA to AF encompass chronic intermittent hypoxia, disruptions in the autonomic nervous system, inflammatory responses, and alterations in ion channel function. Continuous positive airway pressure (CPAP) therapy emerges as the frontline treatment for moderate to severe OSA, effectively alleviating symptomatic manifestations and potentially mitigating cardiovascular risks. However, the influence of CPAP on AF among OSA patients remains a subject of debate. Some investigations underscore its beneficial effects, including the reversal of atrial remodeling, enhanced atrial conduction, decreased AF incidence, and improved outcomes post-AF ablation in CPAP-treated individuals. Conversely, other studies reveal neutral or insignificant impacts. This review delves into the repercussions of CPAP therapy on AF in OSA patients, exploring potential explanations for the discrepancies observed across existing research endeavors. By consolidating current evidence and pinpointing areas ripe for further inquiry, this review aspires to inform clinical decision-making regarding the management of OSA-related AF.
阻塞性睡眠呼吸暂停（OSA）是多种心血管疾病的独立危险因素，尤其是心房颤动（AF），心房颤动与发病率和死亡率的升高密切相关。将OSA与AF联系起来的复杂病理生理途径包括慢性间歇性缺氧、自主神经系统紊乱、炎症反应以及离子通道功能改变。持续气道正压通气（CPAP）治疗是中重度OSA的一线治疗方法，可有效缓解症状并可能降低心血管风险。然而，CPAP对OSA患者房颤的影响仍是一个有争议的话题。一些研究强调了其有益效果，包括心房重构的逆转、心房传导增强、房颤发生率降低以及CPAP治疗个体房颤消融术后预后改善。相反，其他研究显示其影响为中性或不显著。本综述深入探讨了CPAP治疗对OSA患者房颤的影响，探索现有研究中观察到的差异的潜在原因。通过整合当前证据并确定有待进一步研究的领域，本综述旨在为OSA相关房颤管理的临床决策提供参考。
