Atrial Fibrillation Clinical Trial
Official title:
Screening for Sleep Apnea in Patients Undergoing Atrial Fibrillation Ablation
Diagnosis and treatment of sleep apnea with continuous positive airway pressure (CPAP) therapy has been shown to decrease arrhythmia recurrence in patients with AF following ablation. However, patients with AF undergoing ablation are not routinely screened for sleep apnea, despite an estimated sleep apnea prevalence of 25% in the general population, and perhaps higher among patients with AF. Home sleep testing is frequently used for evaluation of sleep apnea.
The American Academy of Sleep Medicine considers atrial fibrillation (AF) to be high risk for
sleep disordered breathing, and recommends that those with AF be evaluated for sleep apnea in
its clinical guidelines. However, this has not yet become standard practice. The primary
reasons for this are that sleep apnea remains under-suspected and under-diagnosed by
electrophysiology physicians treating patients with AF, overnight sleep studies are
cumbersome and are frequently associated with patient discomfort and high cost, and a
mechanism for coordinating sleep apnea screening and treatment referral has not been
established in electrophysiology clinics.
The gold standard for the diagnosis of sleep apnea is overnight polysomnography, typically
conducted in a sleep laboratory, which can be costly and cumbersome for patients. Home sleep
studies are FDA-approved for the diagnosis of sleep apnea and offer patients the opportunity
to be assessed in a more natural sleep environment, and often in a more timely manner.
It has been demonstrated that diagnosis and treatment of sleep apnea reduces the risk of
arrhythmia recurrence following AF ablation to a level comparable to those without sleep
apnea. The goal of this study is to examine the feasibility of screening all patients
undergoing AF ablation for sleep apnea, and to refer those patients with sleep apnea for
evaluation and treatment by a sleep specialist.
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