Atrial Fibrillation in Obstructive Sleep Apnoea

heart rateAtrial fibrillation is an irregularity in heart rate and rhythm which has rapidly increasing incidence. One recent study has shown that obstructive sleep apnoea (OSA) is prevalent among patients with AF. The article, which was published in the World Journal of Cardiology, highlighted multiple studies which have supported a role of OSA in the initiation and progression of AF. This association has been independent of obesity, body mass index and hypertension. Instability of autonomic tone and wide swings in intrathoracic pressure are seen in OSA.

Various findings have been presented by the study:

  • Sleep apnoea lowers the atrial effective refractory period, which is the resting phase of the heart during its regular beating cycle, thus promoting pulmonary vein discharges and atrial dilation and therefore atrial fibrillation

  • Sleep apnoea not only promotes initiation of atrial fibrillation but also makes management of atrial fibrillation difficult

  • Drug therapy and electrical cardioversion for atrial fibrillation are less successful in presence of sleep apnoea

  • After catheter ablation of atrial fibrillation in patients with sleep apnoea, there is a higher risk of recurrence of arrhythmia (irregular heart beat)

  • Treatment of obstructive sleep apnoea with continuous positive airway pressure (CPAP) has been shown to improve control of atrial fibrillation. However, additional studies are needed to establish a stronger relationship between treatment of sleep apnoea and success of therapies for atrial fibrillation.

  • People who have obstructive sleep apnoea, therefore, should be screened for atrial fibrillation. There is a need for guidelines to screen for obstructive sleep apnoea as a part of the management for atrial fibrillation.

You can read more about these findings here:

http://www.ncbi.nlm.nih.gov/pubmed/23802045

Image courtesy of digitalart / FreeDigitalPhotos.net

Somnowell Inventor - Visiting Professor Simon Ash FDS MSc MOrth BDS

Prof. Ash is the inventor of the highly successful SOMNOWELL Chrome device for snoring and sleep apnoea.

The Somnowell Chrome is made to exacting standards in the Somnowell laboratory under the supervision of Visiting Professor Simon Ash. Prof. Ash and his master technicians create each Somnowell Chrome device using their wealth of experience and expertise.

Prof. Ash works at the forefront of his profession. He is a Consultant and Specialist Orthodontist with over 30 years clinical experience, with a special interest in sleep related breathing disorders, TMJD, and bruxism. He currently works in Harley Street London and two private hospitals in London as part of a multi-disciplinary team managing snoring and sleep apnoea, and is Visiting Professor of Orthodontics at the BPP University.