Meta-analysis Of The Influence Of Obstructive Sleep Apnea Syndrome On The Recurrence Of Atrial Fibrillation After Ablation

Objective:Obstructive sleep apnea(OSA)is associated with the management of atrial fibrillation(AF).This meta‐analysis was conducted to evaluate the effect of OSA and its severity or treatment on the AF recurrence after cardiac ablation and patients with different ages,weights and length of follow-up.Methods:We searched CNKI,Wanfang,Weipu,Pub Med,EMBASE,Cochrane databases(from inception to July 2020)for relevant articles.Study about OSA and AF were collected to evaluated the risk of atrial fibrillation recurrence after successful cardiac ablation in patients with OSA.Results:Sixteen observational studies with a total of seven thousand and seventy-four patients after successful cardiac ablation were included in the analysis.Results showed that risk of atrial fibrillation recurrence after cardiac ablation was significantly higher in OSA group than non-OSA group(OR,1.64;95%CI,1.28-2.10;p,0.000).In the subgroup analysis,a higher risk of atrial fibrillation recurrence in patients at least 60 years old(≥60 years old: OR,1.69;95%CI,1.50-1.90,p,0.000 vs<60 years old: OR,1.60;95%CI,1.10-2.33,p,0.014),with longer follow-up time(≥1year: OR,1.78;95%CI,1.47-2.15;p,0.000 vs <1 year: OR,1.68;95%CI,1.50-1.89;p,0.000),with a body mass index(BMI)of at least 30(≥30: OR,1.75;95%CI,1.52-2.02;p,0.000 vs BMI<30: OR,1.68;95%CI,1.25-2.26;p,0.001).In studies related to OSA severity,the risk of atrial fibrillation recurrence was significantly higher in patients with severe OSA than in patients with non-severe OSA(OR = 1.78,95%CI=(1.25,2.53),P=0.001).The risk of atrial fibrillation recurrence was significantly higher in the moderate to severe OSA group than in the mild OSA group,and the difference was obvious(OR = 1.91,95%CI=(1.43,2.57),P=0.000).Among OSA patients with AF after successful atrial ablation,the use of continuous positive airway pressure(CPAP)could significantly decrease risk of recurrent AF(OR,0.37;95%CI,0.29-0.48;P,0.000).Conclusion:OSA is closely associated with AF recurrence after cardiac ablation,especially in elderly and obese patients,and the higher the risk of recurrence over time.At the same time,the recurrence of atrial fibrillation is significantly associated with the severity of OSA.Patients with more severe OSA complications have a higher risk of atrial fibrillation recurrence,and effective CAPA treatment can reduce the risk.Overall,among OSA patients with AF after successful atrial ablation,in addition actively stratifying severity and CAPA treatment,we should pay more attention to weight management,age classification,early intervention,and the need for more long-term follow-up.