Sleep Apnea Increases Risk of Atrial Fibrillation After Bypass Surgery

Adrian Baranchuk MD FACC FRCPC Associate Professor of Medicine Director, EP Training Program Queen's University Kingston, Ontario, CanadaMedicalResearch.com Interview with:
Adrian Baranchuk MD FACC FRCPC
Associate Professor of Medicine
Director, EP Training Program Queen’s University
Kingston, Ontario, Canada

Medical Research: What are the main findings of the study?

Dr. Baranchuk: In this study, we investigated whether obstructive sleep apnea increases the risk of atrial fibrillation after coronary artery bypass surgery. We found the risk to increase by approximately two-fold for patients with obstructive sleep apnea, suggesting that this disease is a strong predictor of atrial fibrillation after coronary artery bypass surgery.

We also found that the risk increases in patients with more severe obstructive sleep apnea.

This is an important association to explore since atrial fibrillation after coronary artery bypass surgery increases patient mortality, the risk of stroke, hospital stay, healthcare costs, and has substantial burden on patients and their families. It is also a common complication of the surgery, occurring in up to half of the patients. Knowing which factors increase its risk gives us a better understanding of how to manage it and mitigate its negative consequences.

Medical Research: What was most surprising about the results?

Dr. Baranchuk: Factors like age, obesity, and many others can influence the risk of atrial fibrillation after coronary artery bypass surgery. Some studies we investigated in our systematic review controlled for these factors, and obstructive sleep apnea became a stronger risk factor when these study results were pooled.

This suggests that obstructive sleep apnea independently predicts which patients are more likely to have atrial fibrillation after coronary artery bypass surgery.

Medical Research: What should clinicians and patients take away from your report?

Dr. Baranchuk: Healthcare specialists of multiple disciplines, including cardiologists, anesthesiologists, and cardiac surgeons should equip themselves with the necessary knowledge and tools to both recognize and optimally manage obstructive sleep apnea. This can include screening patients for obstructive sleep apnea using questionnaires, as well as following up to date guidelines and using the best available evidence to manage it.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Baranchuk: We were not able to identify any studies that investigated the effectiveness of obstructive sleep apnea management strategies on reducing the risk and negative consequences of atrial fibrillation following coronary artery bypass surgery. This is an appealing research topic to explore, since it can inform whether managing obstructive sleep apnea, such as using continuous positive airway pressure, has a positive impact for outcomes in this patient population.

Citation:

Obstructive Sleep Apnea as a Predictor of Post Coronary Artery Bypass Graft Atrial Fibrillation: A Systematic Review and Meta-analysis
Qaddoura, Amro et al.

Canadian Journal of Cardiology

Received: September 23, 2014; Received in revised form: October 10, 2014; Accepted: October 13, 2014; Published Online: October 14, 2014

DOI: http://dx.doi.org/10.1016/j.cjca.2014.10.014