Objective. To assess the obstructive sleep apnea-hypopnea syndrome impact on paroxysmal atrial fibrillation in patients with ischemic heart disease and/or arterial hypertension.

Materials and methods. We examined 87 non-valvular paroxysmal atrial fibrillation patients with concomitant ischemic heart disease and/or arterial hypertension undergoing pharmacological cardioversion; mean age 55.01±8.96 yrs. Sleep study was performed at all patients by a portable cardiorespiratory device «Cardiotechnika-04-3Р» (INCART, Russia). The atrial fibrillation recurrence data was obtained for every patient during one year following cardioversion. The patients were divided into 2 groups according to the atrial fibrillation recurrence: group 1 — without recurrence; group 2 — with recurrence. The statistical analysis was performed using STATISTICA 10.0 (StatSoft, Inc., USA) and RStudio 1.1.18 programs.

Results. The recurrence rate of atrial fibrillation in 1 year in the study sample was 60.92% (53 patients). The first recurrence appearance correlated positively with the apnea/hypopnea index (R=-0.729; p<0.001). The apnea/hypopnea index showed an association with the early atrial fibrillation recurrence (ОR 1.13; 95% CI 0.027-0.122; p=0.002). In order to determine the threshold for the apnea/hypopnea index a ROC analysis was carried out (AUC=0.882). The calculated ROC curve apnea/hypopnea index >7 episodes/hour showed 86.79% sensitivity and 76.47% specificity for detecting the first atrial fibrillation recurrence over 1 year.

Conclusion. Presence of obstructive sleep apnea-hypopnea syndrome with an apnea/hypopnea index >7 episodes/hour might be used as a screening tool for predicting atrial fibrillation recurrence during the first year after pharmacological cardioversion in atrial fibrillation patients with ischemic heart disease and/or arterial hypertension.

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Автор(ы): V. I. Shyshko, T. I. Balabanovich