Evaluation of obstructive sleep apnea among consecutive patients with all patterns of atrial fibrillation using WatchPAT home sleep testing.

ABBREVIATIONS: Obstructive sleep apnea (OSA), atrial fibrillation (AF), home sleep test (HST), apnea-hypopnea index (AHI), continuous positive airway pressure (CPAP), Epworth Sleepiness Scale (ESS), Center of Excellence (COE), Mayo AF-Specific Symptom Inventory (MAFSI), Atrial Fibrillation Effect Quality of Life (AFEQT), body-mass index (BMI), oxygen desaturation index (ODI) BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice and is associated with significant morbidity, mortality, and financial burden. Obstructive sleep apnea (OSA) is more common in individuals with AF and may impair the efficacy of rhythm control strategies including catheter ablation. However, the prevalence of undiagnosed OSA in all-comers with AF is unknown.

DESIGN: This pragmatic, phase IV prospective cohort study will test 250-300 consecutive ambulatory AF patients with all patterns of atrial fibrillation (paroxysmal, persistent, and long-term persistent) and no prior sleep testing for OSA using the WatchPAT system, a disposable home sleep test (HST). The primary outcome of the study is the prevalence of undiagnosed OSA in all-comers with atrial fibrillation.

RESULTS: Preliminary results from the initial pilot enrollment of approximately 15% (N=38) of the planned sample size demonstrate a 79.0% prevalence of at least mild (AHI≥5) OSA or greater in consecutively enrolled patient with all patterns of AF.

CONCLUSIONS: We report the design, methodology, and preliminary results of our study to define the prevalence of OSA in AF patients. This study will help inform approaches to OSA screening in patients with AF for which there is currently little practical guidance.