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Atrial Fibrillation Connected with Sleep Apnea

Posted On August 5, 2015
August 05, 2015

As more studies look at the connection between Coronary conditions and Sleep Apnea, we find evidence that sleep apnea treatment can greatly reduce risks for coronary complications.

Atrial fibrillation (AF) is the most common type of arrhythmia. An arrhythmia is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. AF occurs if rapid, disorganized electrical signals cause the heart’s two upper chambers—called the atria to fibrillate. The term “fibrillate” means to contract very fast and irregularly.

In AF, blood pools in the atria. It isn’t pumped completely into the heart’s two lower chambers, called the ventricles. As a result, the heart’s upper and lower chambers don’t work together as they should.

People who have AF may not feel symptoms, However, even when AF isn’t noticed,  it can increase the risk of stroke. In some people, AF can cause chest pain or heart failure, especially if the heart rhythm is very rapid. For adults 18 and older, a normal resting heart rate is between 60 and 100 beats per minute (BPM), depending on the person’s physical condition and age. There is no definitive medical advice on when a resting heart rate is too high, but most medical experts agree that a consistent heart rate in the upper levels can put too much stress on the heart and other organs. A low heart rate in somebody who is having dizziness and lightheadedness may indicate that they have an abnormality.

In the last few years, there has been mounting evidence for an important association between Atrial fibrillation and Obstructive sleep apnea. In fact, the prevalence of sleep apnea among patients with AF is estimated to be about 32%–49%, according to a 2012 report in the journal Current Cardiology Reviews.

Obstructive sleep apnea (OSA) is a sleep disorder defined as the unconscious stoppage of breathing for short periods of time throughout a night’s sleep. With OSA, there is a soft tissue obstruction of the upper airway, which negatively impacts the flow of air.Pauses in breathing can be just a few seconds to minutes, and occur as little as five to as many as 30 times per hour. OSA is further characterized as a partial reduction (hypopnea) to complete pauses (apnea) in breathing that can last longer than 10 seconds. Depending upon the number of times per hour these episodes are experienced during the course of a night, the severity is classified as mild, moderate or severe.

There is increasing evidence linking OSA and AF due to left atrial enlargement that occurs as a result of elevated left ventricular pressures from hypertension induced diastolic dysfunction. Diastolic dysfunction is an abnormality in how the heart fills with blood during diastole. The heart muscles do not relax in a normal manner and the heart may fill too slowly, asynchronously or with an elevation in filling pressure.

Patients with untreated OSA were at 82% risk of recurrence of AF after successful cardioversion, while the control group had a 53% risk of recurrence. Meanwhile, patients with OSA who were effectively treated had a 42% risk of recurrence of AF after cardioversion. Studies involving OSA patients with AF have shown that treatment of OSA improves left ventricular systolic function, decreases sympathetic activity, reduces systolic blood pressure and improves quality of life.

OSA treatment has the largest body of evidence supporting this potential role, and it appears that it may reduce the frequency of AF by modifying some the physiologic factors thought to promote this arrhythmia including sympathetic activation, systemic inflammation, hypoxemia, cardiac dysfunction, and hypertension. As many of these cardiac effects have been postulated to play a role in AF, it is not surprising that there is mounting evidence to suggest that OSA treatment can reduce the frequency of AF.

Treatment of OSA may have profound cardiovascular effects. Several studies have reported that OSA treatment decreases stroke volume and cardiac output in patients with AF and OSA. The evidence thus far seems to suggest that relief of the airway obstruction that leads to nocturnal desaturations in OSA patients may result in improvement or reversal of cardiac arrhythmias, including AF.

Treating OSA can reduce the likelihood of developing a AF by up to 42%, that is a very big number considering 610,000 deaths occur every year due to coronary issues. If you suspect you might have sleep apnea, been diagnosed or would like to find out how you can avoid the high risk of developing other conditions, contact one of our medical concierges today at 1-855-863-4537 to schedule a consultation.

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