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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/28227

Title: The why, when and how to test for obstructive sleep apnea in patients with atrial fibrillation.
Authors: Desteghe, Lien
Hendriks, Jeroen M. L.
McEvoy, R. Doug
Chai-Coetzer, Ching Li
Dendale, Paul
Sanders, Prashanthan
Heidbuchel, Hein
Linz, Dominik
Issue Date: 2018
Citation: Clinical Research in Cardiology, 107(8), p. 617-631
Abstract: Sleep apnea is associated with increased cardiovascular risk and may be important in atrial fibrillation (AF) management. It is present in up to 62% of the AF population and is highly under-recognized and underdiagnosed. Obstructive sleep apnea (OSA) is strongly associated with AF and non-randomized trials have shown that its treatment can help to reduce AF recurrences and maintain sinus rhythm. The 2016 European Society of Cardiology guidelines for the management of AF recommend that AF patients should be questioned regarding the symptoms of OSA and that OSA-treatment should be optimized to improve AF treatment results. However, strategies on how to implement OSA testing in the standard work-up of AF patients are not provided in the guidelines. Additionally, overnight OSA monitoring rather than interrogation for OSA-related clinical signs alone may be necessary to reliably identify OSA in the majority of AF patients. This review summarizes the available clinical data on OSA in AF patients, and discusses the following key questions: Why and When is testing for OSA needed in AF patients? How and Where should it be performed and coordinated? and Who should test for OSA? To implement OSA testing in a cardiology or electrophysiology clinic, we propose a multidisciplinary integrated care approach based on a chronic care model. We describe the tools, infrastructure and coordination needed to test for OSA in the standard workup of patients with symptomatic AF prior to the initiation of directed invasive or pharmacological rhythm control management.
URI: http://hdl.handle.net/1942/28227
DOI: 10.1007/s00392-018-1248-9
ISI #: 000439146800001
ISSN: 1861-0684
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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