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Effect of obstructive sleep apnea and its treatment of atrial fibrillation recurrence after radiofrequency catheter ablation: A meta‐analysis
Author(s) -
Congrete Soontharee,
Bintvihok Maythawee,
Thongprayoon Charat,
Bathini Tarun,
Boonpheng Boonphiphop,
Sharma Konika,
Chokesuwattanaskul Ronpichai,
Srivali Narat,
Tanawuttiwat Tanyanan,
Cheungpasitporn Wisit
Publication year - 2018
Publication title -
journal of evidence‐based medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.885
H-Index - 22
ISSN - 1756-5391
DOI - 10.1111/jebm.12313
Subject(s) - medicine , obstructive sleep apnea , atrial fibrillation , continuous positive airway pressure , catheter ablation , cardiology , meta analysis , observational study , sleep apnea , ablation , anesthesia
Background/objectives Patients with obstructive sleep apnea (OSA) have an increased the risk of developing atrial fibrillation (AF). However, it remains unclear if patients with OSA carry a higher risk of recurrent AF after successful catheter ablation. This meta‐analysis was conducted (1) to evaluate the association between OSA and recurrent AF after catheter ablation, and (2) to assess the effect of continuous positive airway pressure (CPAP) on the risk of recurrent AF in patients with OSA. Methods A comprehensive literature review was conducted using MEDLINE, EMBASE, Cochrane databases from inception through July 2017 to identify studies that evaluated the risk of recurrent AF after successful catheter ablation in patients with OSA were included. Effect estimates from the individual study were extracted and combined using random‐effect, generic inverse variance method of DerSimonian and Laird. Results Seven observational studies with a total of 4572 patients AF after successful catheter ablation were enrolled. Compared to patients without OSA, the pooled OR of recurrent AF in patients with OSA was 1.70 (95% CI, 1.40‐2.06, I 2 = 0). Among OSA patients with AF after successful catheter ablation, the use of CPAP was significantly associated with decreased risk of recurrent AF with pooled OR of 0.28 (0.19‐0.40, I 2 = 0). Egger's regression asymmetry test was performed and showed no publication bias for the associations of OSA and CPAP with recurrent AF. Conclusions Our meta‐analysis suggested a significant association between OSA and recurrent AF after catheter ablation. The use of CPAP in patients with OSA is associated with reduced risk of recurrent AF after catheter ablation.