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In patients with obstructive sleep apnoea (OSA), ineffective inspiration against the occluded upper airways during obstructive respiratory events cause intrathoracic pressure swings resulting in myocardial stretch of the heart chambers and changes in transmural pressure gradients. Additionally, obstructive respiratory events induce intermittent apnoea-associated hypoxemia and hypercapnia as well as sympathetic activation and subsequent haemodynamic fluctuations.1 Long-term OSA has been shown to be associated with atrial remodelling characterized by atrial …

Apnoea-associated intrathoracic pressure swings create a dynamic arrhythmogenic atrial substrate during sleep