CLINICAL CHARACTERISTICS OF PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION AND CONCOMINANT OBSTRUCTIVE SLEEP APNOEA/HYPOPNOEA

Background. In recent years growing evidence has suggested the potential role of obstructive sleep apnoeahypopnoea (OSAH) in the genesis of atrial fibrillation (AF), but the precise mechanisms linking these two conditions are currently unknown. The aim. To assess the prevalence of OSAH in a sample of non-valvular AF patients and evaluate the clinical profile of non-valvular AF patients depending on the severity of sleep-disordered breathing. Material and methods. We enrolled into the study 172 patients with non-valvular AF (mean age 55.54±8.43 years; 68.02% males). The study subjects were divided into 4 groups according to the results of clinical laboratory evaluation (typical complaints, clinical markers, the Epworth scale scores and cardiorespiratory monitoring). Results. OSAH patients had higher body mass index, greater waist and neck circumference than non-OSAH patients (p<0.01); they more often had cardiac comorbidities (arterial hypertension, chronic heart failure) (p<0.01) and diabetes mellitus, and their parameters of blood oxygen saturation as well as apnea-hypopnea index (AHI) were significantly worse. Mild OSAH patients were less likely than moderate/severe OSAH patients to have permanent AF (p<0.01). Conclusion. OSAH appears to be highly prevalent in non-valvular AF patients and has been estimated to be present in approximately 78.49% in the study sample (it affects predominantly men with abdominal type of obesity). With the increase in OSAH severity and the level of AHI the prevalence of permanent AF and the risk of thromboembolic disorders by the CHA2DS2-VASc scale significantly rise.