TY - JOUR
T1 - Impact of nocturnal hypoxemia on the recurrence of atrial tachyarrhythmia after catheter ablation of atrial fibrillation
AU - Suzuki, Keisuke
AU - Miyamoto, Koji
AU - Wakamiya, Akinori
AU - Ueda, Nobuhiko
AU - Nakajima, Kenzaburo
AU - Kamakura, Tsukasa
AU - Wada, Mitsuru
AU - Yamagata, Kenichiro
AU - Ishibashi, Kohei
AU - Inoue, Yuko
AU - Noda, Takashi
AU - Nagase, Satoshi
AU - Aiba, Takeshi
AU - Yambe, Tomoyuki
AU - Kusano, Kengo
N1 - Funding Information:
We would like to thank Editage (www.editage.com) for English language editing.
Publisher Copyright:
© 2021, Springer Japan KK, part of Springer Nature.
PY - 2022/5
Y1 - 2022/5
N2 - Factors causing atrial tachyarrhythmia recurrence after catheter ablation (CA) of atrial fibrillation (AF) remain undetermined. This study aimed to investigate the effect of nocturnal hypoxemia on the recurrence of atrial tachyarrhythmia after CA of AF. Among 594 patients with AF who underwent an ambulatory sleep study at the National Cerebral and Cardiovascular Center, Suita, Osaka, Japan (2014–2019), 365 underwent CA of AF; 290 patients who underwent CA were followed up for > 3 months. Multivariate Cox regression analysis was used to calculate hazard ratios (HRs) using clinical variables, to identify the independent predictors of atrial tachyarrhythmia recurrence after the final CA. Atrial tachyarrhythmia recurred in 45 of 290 (15.5%) patients during the median follow-up period of 479 days (interquartile range 225–1002). On the performing multivariate analysis of the data of patients who did not receive continuous positive airway pressure (CPAP), severe nocturnal hypoxemia [defined as the percentage of sleep time spent with SaO2 of < 90% (T90) over 20%] [HR 8.53, 95% confidence interval (CI) 1.872–38.814; P < 0.01] and an 1 mL/m2 increase in the left atrial volume index (HR 1.02, 95% CI 1.004–1.044; P = 0.02) were found to be independently associated with the recurrence of atrial tachyarrhythmia. In addition, the rates of freedom from atrial tachyarrhythmia after the final AF ablation with CPAP were significantly lower in the group with more severe nocturnal hypoxemia (Log-rank P = 0.03). In conclusion, it is necessary to consider both, AHI and nocturnal hypoxia while performing an ambulatory sleep apnea study. CA may be less effective in patients with more severe nocturnal hypoxia, despite the administration of CPAP.
AB - Factors causing atrial tachyarrhythmia recurrence after catheter ablation (CA) of atrial fibrillation (AF) remain undetermined. This study aimed to investigate the effect of nocturnal hypoxemia on the recurrence of atrial tachyarrhythmia after CA of AF. Among 594 patients with AF who underwent an ambulatory sleep study at the National Cerebral and Cardiovascular Center, Suita, Osaka, Japan (2014–2019), 365 underwent CA of AF; 290 patients who underwent CA were followed up for > 3 months. Multivariate Cox regression analysis was used to calculate hazard ratios (HRs) using clinical variables, to identify the independent predictors of atrial tachyarrhythmia recurrence after the final CA. Atrial tachyarrhythmia recurred in 45 of 290 (15.5%) patients during the median follow-up period of 479 days (interquartile range 225–1002). On the performing multivariate analysis of the data of patients who did not receive continuous positive airway pressure (CPAP), severe nocturnal hypoxemia [defined as the percentage of sleep time spent with SaO2 of < 90% (T90) over 20%] [HR 8.53, 95% confidence interval (CI) 1.872–38.814; P < 0.01] and an 1 mL/m2 increase in the left atrial volume index (HR 1.02, 95% CI 1.004–1.044; P = 0.02) were found to be independently associated with the recurrence of atrial tachyarrhythmia. In addition, the rates of freedom from atrial tachyarrhythmia after the final AF ablation with CPAP were significantly lower in the group with more severe nocturnal hypoxemia (Log-rank P = 0.03). In conclusion, it is necessary to consider both, AHI and nocturnal hypoxia while performing an ambulatory sleep apnea study. CA may be less effective in patients with more severe nocturnal hypoxia, despite the administration of CPAP.
KW - Atrial fibrillation
KW - Catheter ablation
KW - Nocturnal hypoxemia
KW - Obstructive sleep apnea
KW - Peripheral arterial tonometer
UR - http://www.scopus.com/inward/record.url?scp=85117692704&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85117692704&partnerID=8YFLogxK
U2 - 10.1007/s00380-021-01969-x
DO - 10.1007/s00380-021-01969-x
M3 - Article
C2 - 34677657
AN - SCOPUS:85117692704
VL - 37
SP - 794
EP - 801
JO - Heart and Vessels
JF - Heart and Vessels
SN - 0910-8327
IS - 5
ER -