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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
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01. History of Cardiology
02. Clinical Skills
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05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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34. Public Health and Health Economics
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Treating Obstrutive Sleep Apnea with continuous positive airway pressure may reduce the risk of late recurrence after AF ablation
Session:
Posters 5 - Écran 3 - Arritmologia
Speaker:
Tânia Branco Mano
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Posters
FP Number:
---
Authors:
Tânia Branco Mano; Guilherme Portugal; Pedro Silva Cunha; Bruno Tereno Valente; Ana Lousinha; Catarina Barroso; Rui Cruz Ferreira; Mário Martins Oliveira
Abstract
<p>Obstrutive Sleep Apnea (OSA) has been strongly associated with the onset and recurrence of atrial fibrillation (AF). Although many OSA patients (pts) are treated with Continuous Positive Airway Pressure (CPAP), its impact on the efficacy of AF catheter-based therapy remains unclear. The aim of the present study is to characterize short and long-term efficacy of AF ablation in pts with OSA who received CPAP.</p> <p><strong>Methods:</strong> Retrospective analysis of pts who underwent polysomnography before pulmonary veins isolation in AF ablation. CPAP treatment was recommended to all pts with moderate/severe OSA. Demographic, clinical, ECG and echocardiographic data were collected from electronic medical files. An external loop recorder (ELR) was employed during the blanking period in all pts. Primary outcome was atrial arrhythmia (AT/AF) and AF recurrence in pts with (group A) and without (group B) OSA, at 3 months (blanking period) and one year after catheter-ablation. Secondary outcomes: duration and burden of AT/AF detected via the ELR.</p> <p><strong>Results</strong>: 167pts were included (55.7% males, mean age 55.9 years, with a follow-up >1 year after ablation). Mean duration of clinical history of AF (paroxysmal AF - 57.5%) was 56 months, with 22% showing structural heart disease. Ablation was performed with cryoballoon in 34.7% and with radiofrequency in 65.3% of the cases. Group A (21pts, 12.6%), had higher body mass index (HR 4.150, 95%CI 2.131-6.168, p<0.0001) and higher left atrial volume (HR 1.878, 95%CI 1.432-9.451, p=0.01). ELR data (blanking period) showed a slightly longer duration of AT/AF in OSA pts (mean 15.65 hours vs. 5.99 hours, p=0,19), and a statistically significant higher burden of AT/AF (mean percentage of time with AT/AF 28.19% vs. 5.29%, HR 9.091, 95%CI 4.578-41.208, p=0.015). The rate of AT/AF recurrence was similar for both groups during the blanking period (57.1% vs. 51.4%; p=0.65). At one year after ablation, AF recurrence and any AT/AF recurrence were not statistically different between groups (19.1% vs. 28.8%, p=0.43 and 42.9% vs. 24.9%, p=0.56, respectively).</p> <p><strong>Conclusion:</strong> In this cohort, OSA pts treated with CPAP showed short and long-term recurrence of atrial tachyarrhythmias similar to those without OSA. However, when recurrence was observed, OSA pts had a higher arrhythmia burden.</p>
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