ASSOCIATION BETWEEN SLEEP APNEA AND ATRIAL FIBRILLATION RECURRENCE POST-ABLATION

Abstract

Atrial fibrillation (AF) recurrence after catheter ablation remains a significant clinical concern, and identifying modifiable risk factors is essential for improving outcomes. Sleep apnea has been implicated in cardiac remodeling and arrhythmogenesis, but its role in AF recurrence post-ablation is not well established. This study aimed to investigate the association between sleep apnea and AF recurrence after catheter ablation. In this cohort study, 100 patients who underwent catheter ablation for AF were evaluated for sleep apnea via polysomnography or validated home sleep tests. Baseline demographics, comorbidities, echocardiographic parameters, and thyroid function were recorded. AF recurrence was monitored at 1, 3, 6, and 12 months post-ablation using Holter monitoring. Multivariable Cox regression and Kaplan-Meier analyses were employed to determine predictors of recurrence.Patients with sleep apnea were significantly older, had higher BMI, and a greater burden of comorbidities. Echocardiographic data showed reduced LVEF and enlarged LA volume in the sleep apnea group. AF recurrence at 12 months was observed in 48% of sleep apnea patients versus 22% in controls (p < 0.01). Cox regression confirmed sleep apnea (HR 2.1; 95% CI 1.4–3.2; p = 0.001), elevated TSH, and BMI as independent predictors. Kaplan-Meier analysis demonstrated significantly lower recurrence-free survival in the sleep apnea group. Sleep apnea is a strong and independent predictor of AF recurrence following catheter ablation. Integrating sleep apnea screening and management into AF treatment protocols may enhance long-term outcomes.