The Risk Profile for Obstructive Sleep Apnea Does Not Affect the Recurrence of Atrial Fibrillation


Address for reprints: Luigi Padeletti, Professor, Istituto di Clinica Medica e Cardiologia, Viale Morgagni 85, 50134 Firenze. Italy. Fax: 0039 055 4277608; e-mail:


Background: Obstructive sleep apnea (OSA) has been linked to increased prevalence and recurrence of atrial fibrillation (AF). We hypothesized that OSA may aggravate AF in patients with pacemakers implanted for sinus bradycardia who had documented paroxysmal AF.

Methods: Seventy-two patients (36 M, aged 77 ± 6 years) completed the study. All patients received a dual-chamber pacemaker equipped with diagnostic and preventive functions for AF. OSA was diagnosed with the Berlin Questionnaire, which is validated to identify patients with OSA. Four-month continuous pacemaker recordings were collected for all patients.

Results: OSA was diagnosed in 28% of patients. Patients at high risk for OSA (HR group) and patients at low risk for OSA (LR group) were equivalent for gender, age, and body mass index. The rate of hypertension was higher in HR than in LR group (90% vs 44%, P < 0.01). The prevalence of paroxysmal AF during the study period was similar in HR and LR group (53% vs 44%, P = NS). Overall number of AF episodes per month was not significantly different between HR and LR group (7 ± 13 vs 36 ± 122, P = NS). Similarly, AF burden (AF%) was not significantly different between HR and LR group (0.3 ± 0.6 vs 2.0 ± 4.8, P = NS). Circadian distribution of AF episodes was similar in both groups.

Conclusion: Long-term pacemaker recording of AF recurrence, AF burden, and its circadian distribution is similar in patients with paroxysmal AF at high risk for OSA and those at low risk for OSA.