Sleep-Related Hypoxia Tied to Incident Atrial Fibrillation

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Findings consistent across three measures of hypoxia, when adjusting for pulmonary physiology

By Lori Solomon HealthDay Reporter

WEDNESDAY, Nov. 22, 2023 (HealthDay News) — Sleep-related hypoxia is associated with incident atrial fibrillation (AF), according to a study published online Nov. 10 in the Journal of the American Heart Association

Catherine M. Heinzinger, D.O., from the Cleveland Clinic, and colleagues examined the association between sleep-disordered breathing, hypoxia, and pulmonary physiology on atrial fibrillation. The analysis included 42,057 patients who underwent sleep studies at a single institution between 2000 and 2015. 

The researchers found that 4.6 percent of participants developed AF over five years. An increase of 10 units in the apnea-hypopnea index was associated with a trend toward higher AF risk (hazard ratio, 1.02; 95 percent confidence interval [CI], 1.00 to 1.03). Associations were seen for a 10-unit increase in percentage time oxygen saturation <90 percent and 10-unit decreases in mean and minimum oxygen saturation with higher AF risk (hazard ratios [95 percent CI], 1.06 [1.04 to 1.08], 1.30 [1.18 to 1.42], and 1.09 [1.03 to 1.15], respectively). Among the subset of 9,683 patients with spirometry data, only hypoxia remained significantly associated with incident AF in an adjusted analysis. 

“Findings set the stage to better understand hypoxic mechanisms leading to atrial arrhythmia and indicate a potential role for nocturnal supplemental oxygen therapy in prevention of atrial arrhythmogenesis,” the authors write.

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