Preoperative Treatment of Obstructive Sleep Apnea With Positive Airway Pressure is Associated With Decreased Incidence of Atrial Fibrillation After Cardiac Surgery

Jan 24, 2017Journal of cardiothoracic and vascular anesthesia

Using Breathing Support Before Surgery for Sleep Apnea May Lower Risk of Irregular Heartbeat After Heart Surgery

AI simplified

Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Among 192 patients with obstructive sleep apnea, 54% adhered to positive airway pressure therapy preoperatively.

Patients who used positive airway pressure therapy had a lower incidence of postoperative atrial fibrillation (POAF) compared to nonusers, with 47% of users developing POAF versus 66% of nonusers.
The adjusted hazard ratio for developing POAF in patients using therapy was 0.59, indicating a potential protective effect.
No significant differences were found in intensive care unit or hospital length of stay between PAP-adherent and nonadherent groups.
A lower median increase in postoperative creatinine levels was observed in those who adhered to PAP therapy.

AI simplified

OBJECTIVE: Based on clinical studies in the nonsurgical population that positive airway pressure (PAP) therapy for patients with obstructive sleep apnea (OSA) provides benefits for those with atrial fibrillation, the authors tested the hypothesis that PAP in patients with OSA reduces the incidence of postoperative atrial fibrillation (POAF) after cardiac surgery.

DESIGN: Retrospective analysis.

SETTING: Single-center university hospital.

PARTICIPANTS: The study comprised 192 patients in sinus rhythm preoperatively who were undergoing nontransplantation or ventricular assist device implantation cardiac surgery requiring cardiopulmonary bypass but not requiring systemic circulatory arrest, with documented PAP adherence from January 2008 to October 2015.

INTERVENTIONS: Retrospective review of medical records.

MEASUREMENTS AND MAIN RESULTS: POAF was defined as atrial fibrillation requiring therapeutic intervention. Of the 192 patients with OSA, 104 (54%) were documented to be PAP-adherent and 88 (46%) were reported to be PAP-nonadherent. Among PAP users, 49 (47%) developed POAF; among PAP nonusers, 59 (66%) developed POAF. The adjusted hazard ratio was 0.59 (95% confidence interval 0.40-0.86, p<0.01). No differences were observed in intensive care unit length of stay (4.0±3.4 days for PAP-adherent group v 5.0±6.2 days for PAP-nonadherent group; p = 0.22) or hospital length of stay (10.7±6.6 days for PAP-adherent group v 10.9±7.3 days for PAP nonadherent group; p = 0.56). A lower median postoperative creatinine rise was observed in PAP-adherent patients (18.2% [8.3%-37.5%) v 31.3% [13.3%-50%]; p< 0.01).

CONCLUSION: Preoperative PAP use in patients with OSA was associated with a decreased rate of POAF after cardiac surgery.

Full Text

Full text is available at the source.

View full text (XML) ↗View full text ↗

Preoperative Treatment of Obstructive Sleep Apnea With Positive Airway Pressure is Associated With Decreased Incidence of Atrial Fibrillation After Cardiac Surgery

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief