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Benefit of sleep study in all patients with atrial fibrillation and BMI> 28,0 Kg/m2 before catheter ablation.
Session:
Posters (Sessão 1 - Écran 2) - Arritmias 1 - Fibrilhação Auricular 1
Speaker:
Rui Carlos Gregório Antunes Coelho
Congress:
CPC 2022
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.2 Atrial Fibrillation - Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Rui Antunes Coelho; Leonor Parreira; José Maria Farinha; Ana Fátima Esteves; António Pinheiro Cumena Candjondjo; Joana Silva Ferreira; Jéni Quintal; Ana Rita Marinheiro; Ana Rita Piteira; Pedro Campos Amador; Dinis Mesquita; Artur Lopes; Susana Sousa; Rui Caria
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Background:</u> Sleep apnea and obesity are known risk factors for atrial fibrillation recurrence after catheter ablation. Despite this, in recent atrial fibrillation guidelines, it is unclear in which group of patients should be done sleep study before catheter ablation.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Purpose:</u> Evaluate if body mass index (BMI) has a good discriminative power to predict sleep apnea in patients with atrial fibrillation proposed to catheter ablation.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Methods:</u> We retrospectively studied 160 consecutive patients undergoing catheter ablation of paroxysmal or persistent atrial fibrillation in our institution. We evaluated recurrence of atrial fibrillation after catheter ablation and analysed diagnosis of sleep apnea, body mass index and other comorbidities and clinical characteristics. Receiver operator characteristics (ROC) curve and area under the curve (AUC) were obtained to determine the discriminative power of body mass index as predictor of sleep apnea. Optimal cut-point value was obtained (Youden index) and patients were divided according to this value.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Results:</u> During a mean follow-up time of 22,8 ± 19,9 months, 46 patients (28,8%) had atrial fibrillation recurrence and none died. The recurrence was associated with hypertension, alcohol habits and untreated sleep apnea (HR 3,74; 95% CI 1,89-7,42; <em>p</em> <0,001). Optimal cut-point value of BMI for predicting sleep apnea in patients with atrial fibrillation proposed to catheter ablation was 28,0 Kg/m<sup>2 </sup>(AUC 0,733, <em>p</em> = 0,001, 95% CI 0,640-0,827). The group of patients with BMI of 28,0 Kg/m<sup>2 </sup>had a 4-fold increased risk of sleep apnea (OR 3,95, 95% CI 1,85-8,42, p =0,001) and 2-fold risk of atrial fibrillation recurrence<sup> </sup>(HR 1,96; 95% CI 1,10-3,51; <em>p</em> = 0,023).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Conclusions:</u> In this group of patients undergoing catheter ablation of atrial fibrillation, a BMI ≥ 28,0 Kg/m<sup>2</sup> independently predict sleep apnea and recurrence of atrial fibrillation. In patients with atrial fibrillation proposed to catheter ablation and BMI ≥ 28,0 Kg/m<sup>2 </sup>is reasonable to perform a sleep study before catheter ablation.</span></span></p>
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