Sleep-disordered breathing in patients with atrial fibrillation and normal systolic left ventricular function

Dtsch Arztebl Int. 2009 Mar;106(10):164-70. doi: 10.3238/arztebl.2009.0164. Epub 2009 Mar 6.


Background: Obstructive sleep apnea (OSA) is more common in patients with atrial fibrillation (AFib). Recently, an additional association between central sleep apnea/Cheyne-Stokes respiration (CSA/CSR) and AFib has been described. The aim of this study was to investigate the prevalence and type of sleep-disordered breathing in patients with AFib and normal systolic left ventricular function.

Methods: 150 patients (110 men and 40 women, aged 66.1 +/- 1.7 years) underwent cardiorespiratory polygraphy, capillary blood gas analysis, measurement of NT-proBNP, and echocardiography to determine the diameter of the left atrium (LAD) and the peak systolic pulmonary artery pressure (PAP).

Results: Sleep-disordered breathing was documented in 74% of all patients with AFib (43% had OSA and 31% had CSA/CSR). Patients with CSA/CSR had a higher PAP, a higher apnea-hypopnea index, a greater LAD, and a lower capillary blood pCO(2) than patients with OSA.

Conclusions: Patients with AFib were found to have not only a high prevalence of obstructive sleep apnea, as has been described previously, but also a high prevalence of CSA/CSR. It remains unknown whether CSA/CSR is more common in AFib because of diastolic dysfunction or whether phenomena associated with CSA/CSR predispose to AFib. Further research on this question is needed.

Keywords: atrial fibrillation; echocardiography; oxygen saturation; sleep apnea; sleep disorder.

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnosis*
  • Atrial Fibrillation / epidemiology*
  • Cheyne-Stokes Respiration / diagnosis*
  • Cheyne-Stokes Respiration / epidemiology*
  • Comorbidity
  • Female
  • Germany / epidemiology
  • Humans
  • Incidence
  • Male
  • Polysomnography / statistics & numerical data
  • Risk Assessment
  • Risk Factors
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / epidemiology*
  • Ventricular Function, Left