Behandling av søvnapné hos pasienter med paroksysmal atrieflimmer

Forskere fra OUS, UiO, St. Olav Hospital, NTNU og Lovisenberg Diakonale Sykehus presenterer i denne artikkelen design og rasjonale for en randomisert kontrollert studie som tar sikte på å undersøke effekten av CPAP behandling hos pasienter med paroksysmal atrieflimmer og søvnapné.

Treatment of sleep apnea in patients with paroxysmal atrial fibrillation: design and rationale of a randomized controlled trial

Gunn Marit Traaen, Lars Aakerøy, Tove-Elizabeth Hunt, Britt Øverland, Erik Lyseggen, Pål Aukrust, Thor Ueland, Thomas Helle-Valle, Sigurd Steinshamn, Thor Edvardsen, Hasse Khiabani Zaré, Svend Aakhus, Harriet Akre, Ole- Gunnar Anfinsen, Jan Pål Loennechen & Lars Gullestad

Studien er publisert i Scandinavian Cardiovascular Journal

Abstract:

RATIONALE: Atrial fibrillation is associated with increased mortality as well as morbidity. There is strong evidence for an association between atrial fibrillation and sleep apnea. It is not known whether treatment of sleep apnea with continuous positive airway pressure (CPAP) will reduce the burden of atrial fibrillation.

OBJECTIVE: The Treatment of Sleep Apnea in Patients with Paroxysmal Atrial Fibrillation study will investigate the effects of CPAP in patients with paroxysmal atrial fibrillation and sleep apnea.

DESIGN: The trial has a dual center, randomized, controlled, open-label, parallel design.

METHODS: Two centers will enroll a total of 100 patients with both paroxysmal atrial fibrillation and sleep apnea (apnea-hypopnea index [AHI] ≥ 15 events/h) who are scheduled for catheter ablation. Patients will be randomized in a 1:1 ratio to CPAP or control group (50 patients in each arm). The effects of CPAP treatment on atrial fibrillation will be determined using an implanted loop recorder (Reveal LINQ™, Medtronic) that detects all arrhythmia episodes. The primary endpoint is a reduction of the total burden of atrial fibrillation in the intervention group, after 5 months' follow-up (preablation). Reduction in the arrhythmia recurrence rate after ablation is the main secondary endpoint. All patients will be followed up for 12 months after ablation.

CONCLUSION: This study is the first randomized controlled trial that will provide data on the effects of CPAP therapy in patients with paroxysmal atrial fibrillation and sleep apnea. The results are expected to improve our understanding of the interaction between paroxysmal atrial fibrillation and sleep apnea.