Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-164 - Outcome Of Paroxysmal Atrial Fibrillation Ablation In Patients With And Without Pathological Apnea-hypopnea-index Using A Simple Screening Device (ID 1133)

Abstract

Background: Ablation for paroxysmal atrial fibrillation (pAF) has become a standard procedure. Despite of technical advances during ablation, a considerable number of patients still experiences arrhythmia recurrence. Among other factors, obstructive sleep apnea (OSA) has been discussed to impact ablation success.
Objective: Purpose of the SNORE-AF study (Sleep Apnea Observation and Recurrence of Atrial Fibrillation) is to compare success of pAF ablation among patients with or without pathological apopnea-hypopnea-index (AHI) assessed by a simple screening device for OSA.
Methods: Consecutive patients presenting for their first pAF ablation were included. Exclusion criteria were pathological nocturnal breathing patterns, night work, pregnancy. AHI was determined prior to ablation by a simple screening device for OSA. Pulmonary vein isolation was performed in all patients. Follow-up (FU) was 3 and 12 months. None of the patients received nocturnal ventilation therapy during the study period. Recurrence of atrial tachyarrhythmias was determined clinically and by 7-day Holter-ECG at 3 and 12 months.
Results: In total, 214 patients (age 60.8 years, 63,1% male) were included in the study. 185 patients completed the 3 month FU. Pathological AHI >15/h was found in 41/185 (22,2%). Three months after the initial ablation, 29/41 (70,7%) patients with pathological AHI were free of tachyarrhythmia recurrence compared to 122/144 (84,7%) patients with normal AHI (p=0.041). The 12 month FU completed 158 patients. Pathological AHI >15/h was found in 33/158. Twelve months after the initial ablation 25/33 (75,8 %) patients with pathological AHI were free of tachyarrhythmia recurrence compared to 111/125 (88,8%) patients with normal AHI (p=0.054). In logistic regression analysis pathological AHI (>15/h) proofed to be an independent predictor of atrial tachyarrhythmia recurrence at three months (p=0.019) and at 12 months (p=0.047)
Conclusion: Pathological AHI assessed by a simple screening tool for OSA is correlated with an increased risk for atrial tachyarrhythmia recurrence after AF ablation. Nevertheless, ablation success is still quite high, even in OSA patients. Further studies are needed to evaluate the impact of OSA treatment on ablation success in AF.
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