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Central sleep apnea and atrial fibrillation: A review on pathophysiological mechanisms and therapeutic implications.


ABSTRACT: Precipitating factors and chronic diseases associated with atrial fibrillation (AF) are detailed in the literature. Emerging evidence over the last several decades suggests a potential causal relationship between central sleep apnea (CSA) and AF. Mechanisms including apnea-induced hypoxia with intermittent arousal, fluctuating levels of carbon dioxide, enhanced sympathetic/neurohormonal activation and oxidative stress causing inflammation have been implicated as etiologic causes of AF within this subpopulation. CSA affects the efficacy of pharmacologic and catheter-based antiarrhythmic treatments, which is why treating CSA prior to these interventions may lead to lower rates of AF. Subsequently, a reduction in the AF burden with transvenous phrenic nerve stimulation (TPNS) has become a topic of interest. The present review describes the relationship between these conditions, pathophysiologic mechanisms implicating the role of CSA in development of AF, and emerging therapeutic interventions.

SUBMITTER: Sanchez AM 

PROVIDER: S-EPMC7573647 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Central sleep apnea and atrial fibrillation: A review on pathophysiological mechanisms and therapeutic implications.

Sanchez Alexandra M AM   Germany Robin R   Lozier Matthew R MR   Schweitzer Michael D MD   Kosseifi Semaan S   Anand Rishi R  

International journal of cardiology. Heart & vasculature 20200522


Precipitating factors and chronic diseases associated with atrial fibrillation (AF) are detailed in the literature. Emerging evidence over the last several decades suggests a potential causal relationship between central sleep apnea (CSA) and AF. Mechanisms including apnea-induced hypoxia with intermittent arousal, fluctuating levels of carbon dioxide, enhanced sympathetic/neurohormonal activation and oxidative stress causing inflammation have been implicated as etiologic causes of AF within thi  ...[more]

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