Implications of Obstructive Sleep Apnea for Atrial Fibrillation and Sudden Cardiac Death

Apoor S. Gami, MD, MSc; Virend K. Somers, MD, DPhil


J Cardiovasc Electrophysiol. 2008;19(9):997-1003. 

In This Article

Abstract and Introduction


Obstructive sleep apnea (OSA) is a sleep-related breathing disorder with important cardiovascular consequences, including arrhythmogenesis. The unique pathophysiology of OSA results in multiple intermediate mechanisms that may promote atrial fibrillation, ventricular arrhythmias, and sudden cardiac death. These mechanisms may act acutely to trigger nocturnal dysrhythmias, or chronically by affecting the electrical and myocardial substrates. Burgeoning epidemiological data have identified an increased risk for atrial fibrillation and sudden cardiac death related to OSA. Currently, few data exist to support the efficacy of OSA therapy, namely continuous positive airway pressure, as an adjunct for arrhythmia prevention or management.


Obstructive sleep apnea (OSA) is a sleep-related breathing disorder with pulmonary, neurological, metabolic, and cardiovascular consequences. Important pathophysiological and epidemiological relationships have been identified between OSA and clinically significant arrhythmias, including atrial fibrillation (AF) and sudden cardiac death (SCD). In this review, we will provide an introduction to OSA that is relevant to heart rhythm specialists, describe the potential pathophysiological mechanisms linking OSA to AF and SCD, and discuss the available epidemiological data regarding the relationship between OSA and important arrhythmic outcomes.


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