Obstructive respiratory events and premature atrial contractions after cardioversion

The European Respiratory Journal
Dominik LinzMichael Böhm

Abstract

Recurrence of atrial fibrillation (AF) after electrical cardioversion (ECV) is increased in patients with obstructive sleep apnoea (OSA). In patients with persistent AF, with (n=40) and without (n=32) obstructive respiratory events (OREs) during sedation for ECV, we determined the occurrence of premature atrial contractions (PACs) before and after insertion of a nasopharyngeal tube. The influence of acute obstructive respiratory events on atrial electrophysiology after termination of AF was studied in pigs. Incidence of PACs directly after ECV was higher in patients with OREs compared to those without OREs (7±2 versus 1±1 per 10 s, respectively; p<0.01). Occurrence of PACs could be reduced by 79% by insertion of a nasopharyngeal tube. In a subsequent sleeping study, patients with OREs had higher apnoea-hypopnoea indices and more PACs during night. 16 patient with and four patients without OREs had a relapse of AF during 1 week after ECV (p<0.01). In pigs, acute OREs after 30 min of AF increased occurrence of PACs and vulnerability for reinduction of AF, which could be attenuated by atropine, beta-blockers and renal denervation. OREs are associated with increased occurrence of PACs and more early relapse of AF. OREs increase occ...Continue Reading

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Citations

Oct 16, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Dominik Linz
Apr 24, 2015·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Dominik LinzOlaf Oldenburg
Jun 2, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Dominik LinzMichael Böhm
Apr 10, 2016·Journal of Cardiovascular Electrophysiology·Chrishan J NalliahJonathan M Kalman
Oct 26, 2016·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Dominik Linz
May 29, 2016·Journal of Cardiovascular Electrophysiology·Dominik LinzMichael Böhm
Oct 14, 2018·Current Cardiology Reports·Chrishan J NalliahJonathan M Kalman
Sep 25, 2017·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Johanna StrotmannOlaf Oldenburg
Nov 12, 2018·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Asmaa M AbumuamarColin M Shapiro
Dec 11, 2020·Nature and Science of Sleep·Riva TaumanGiora Pillar
Feb 1, 2021·Cardiac Electrophysiology Clinics·Dominik LinzPrashanthan Sanders
Jun 22, 2019·JACC. Clinical Electrophysiology·Dominik LinzPrashanthan Sanders
Aug 7, 2021·Journal of the American College of Cardiology·Martin R CowieAnita K Simonds

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