Origin of Premature Atrial Beats Induced by Simulated Obstructive Sleep Apnea

Electroanatomic Origin of Premature Atrial Beats in Patients With Paroxysmal Atrial Fibrillation Induced by Intra-thoracic Pressure Swings Simulating Obstructive Sleep Apnea

There is accumulating evidence for obstructive sleep apnea (OSA) as an independent risk factor for paroxysmal atrial fibrillation and for high recurrence rates of atrial fibrillation after ablation therapy. We have previously shown that simulated OSA triggers premature atrial beats (PABs) by acute changes in intra-thoracic pressure. Most episodes of atrial fibrillation are initiated by PABs. However, the origin of PABs induced by intra-thoracic pressure swings is unknown. This study investigates the origin of premature atrial beats induced by intra-thoracic pressure changes that simulate obstructive sleep apnea in patients with atrial fibrillation.

Inclusion Criteria:

• History of ECG-documented paroxysmal atrial fibrillation within the last 12 months and currently in sinus rhythm
• Scheduled for circumferential pulmonary venous isolation treatment
• 18 to 75 years of age
• Signed informed consent

Exclusion Criteria:

• Treated with class III anti-arrhythmic agents (at the moment of pulmonary venous isolation)
• Treated for obstructive sleep apnea
• Previous catheter ablation in the pulmonary veins or left atrium
• Severe structural heart disease
• Mental or physical disability precluding informed consent or compliance with the protocol
• Enrolled in another study that would confound the results of this trial