Advertisement

Submit Manuscripts
Author Information
Subscribe/Renew
Order Reprints
Email Alerts
Feedback
RSS Feed
CME

About the Journal
Editorial Board & Staff

About JACC CME
Hardware/Software Requirements
Contact Us
Policy on Privacy and Confidentiality
Copyright Information

JACC Imaging Homepage JACC Interventions Homepage
Still not a subscriber to JACC Imaging or JACC Interventions?
Click here
to sign up now!

ACC.org
Cardiosmart
Cardiosource
CVN
Imaging Library
JACC Imaging
JACC Interventions

Click here for more guidelines.
2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery
ACC 2009 Advocacy Position Statement: Principles for Comparative Effectiveness Research
ACC 2009 Survey Results and Recommendations: Addressing the Cardiology Workforce Crisis
CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2007; 49:565-571, doi:10.1016/j.jacc.2006.08.060 (Published online 19 January 2007).
© 2007 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2006.08.060v1
49/5/565    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (50)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gami, A. S.
Right arrow Articles by Somers, V. K.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Gami, A. S.
Right arrow Articles by Somers, V. K.

CLINICAL RESEARCH: ATRIAL FIBRILLATION

Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation

Apoor S. Gami, MD*,{dagger}, Dave O. Hodge, MS{ddagger}, Regina M. Herges, BS{ddagger}, Eric J. Olson, MD{dagger},§, Jiri Nykodym, BS*,{dagger}, Tomas Kara, MD*,{dagger} and Virend K. Somers, MD, PhD, FACC*,{dagger},||,1,*

* Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota
{dagger} Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
{ddagger} Department of Biostatistics, Mayo Clinic College of Medicine, Rochester, Minnesota
§ Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
|| Division of Hypertension, Mayo Clinic College of Medicine, Rochester, Minnesota

Manuscript received March 30, 2006; revised manuscript received August 22, 2006, accepted August 28, 2006.

* Reprint requests and correspondence: Dr. Virend K. Somers, 200 First Street SW, Rochester, Minnesota 55905. (Email: somers.virend{at}mayo.edu).

OBJECTIVES: This study sought to identify whether obesity and obstructive sleep apnea (OSA) independently predict incident atrial fibrillation/flutter (AF).

BACKGROUND: Obesity is a risk factor for AF, and OSA is highly prevalent in obesity. Obstructive sleep apnea is associated with AF, but it is unknown whether OSA predicts new-onset AF independently of obesity.

METHODS: We conducted a retrospective cohort study of 3,542 Olmsted County adults without past or current AF who were referred for an initial diagnostic polysomnogram from 1987 to 2003. New-onset AF was assessed and confirmed by electrocardiography during a mean follow-up of 4.7 years.

RESULTS: Incident AF occurred in 133 subjects (cumulative probability 14%, 95% confidence interval [CI] 9% to 19%). Univariate predictors of AF were age, male gender, hypertension, coronary artery disease, heart failure, smoking, body mass index, OSA (hazard ratio 2.18, 95% CI 1.34 to 3.54) and multiple measures of OSA severity. In subjects <65 years old, independent predictors of incident AF were age, male gender, coronary artery disease, body mass index (per 1 kg/m2, hazard ratio 1.07, 95% CI 1.05 to 1.10), and the decrease in nocturnal oxygen saturation (per 0.5 U log change, hazard ratio 3.29, 95% CI 1.35 to 8.04). Heart failure, but neither obesity nor OSA, predicted incident AF in subjects ≥65 years of age.

CONCLUSIONS: Obesity and the magnitude of nocturnal oxygen desaturation, which is an important pathophysiological consequence of OSA, are independent risk factors for incident AF in individuals <65 years of age.

Abbreviations and Acronyms
  AF = atrial fibrillation/flutter
  CI = confidence interval
  HR = hazard ratio
  OSA = obstructive sleep apnea




This article has been cited by other articles:


Home page
 J Am Coll CardiolHome page
K. Monahan, A. Storfer-Isser, R. Mehra, E. Shahar, M. Mittleman, J. Rottman, N. Punjabi, M. Sanders, S. F. Quan, H. Resnick, et al.
Triggering of nocturnal arrhythmias by sleep-disordered breathing events.
J. Am. Coll. Cardiol., November 3, 2009; 54(19): 1797 - 1804.
[Abstract] [Full Text] [PDF]

Home page
 Cleveland Clinic Journal of MedicineHome page
S. SHAFAZAND
Perioperative management of obstructive sleep apnea: Ready for prime time?
Cleveland Clinic Journal of Medicine, November 1, 2009; 76(Suppl_4): S98 - S103.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
C. J. Lettieri, J. F. Collen, A. H. Eliasson, and T. M. Quast
Sedative Use During Continuous Positive Airway Pressure Titration Improves Subsequent Compliance: A Randomized, Double-Blind, Placebo-Controlled Trial
Chest, November 1, 2009; 136(5): 1263 - 1268.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
G. A. Nichols, K. Reinier, and S. S. Chugh
Independent Contribution of Diabetes to Increased Prevalence and Incidence of Atrial Fibrillation
Diabetes Care, October 1, 2009; 32(10): 1851 - 1856.
[Abstract] [Full Text] [PDF]

Home page
 Circ Arrhythm ElectrophysiolHome page
R. L. Verrier and M. E. Josephson
Impact of Sleep on Arrhythmogenesis
Circ Arrhythm Electrophysiol, August 1, 2009; 2(4): 450 - 459.
[Full Text] [PDF]

Home page
 Fam PractHome page
S. Bailes, M. Baltzan, D. Rizzo, C. S Fichten, R. Grad, N. Wolkove, L. Creti, R. Amsel, and E. Libman
Sleep disorder symptoms are common and unspoken in Canadian general practice
Fam. Pract., August 1, 2009; 26(4): 294 - 300.
[Abstract] [Full Text] [PDF]

Home page
 EuropaceHome page
A. Mazza, M. G. Bendini, M. Cristofori, S. Nardi, M. Leggio, R. De Cristofaro, A. Giordano, L. Cozzari, G. Giordano, and R. Cappato
Baseline apnoea/hypopnoea index and high-sensitivity C-reactive protein for the risk of recurrence of atrial fibrillation after successful electrical cardioversion: a predictive model based upon the multiple effects of significant variables
Europace, July 1, 2009; 11(7): 902 - 909.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
R. Mehra, K. L. Stone, P. D. Varosy, A. R. Hoffman, G. M. Marcus, T. Blackwell, O. A. Ibrahim, R. Salem, and S. Redline
Nocturnal Arrhythmias Across a Spectrum of Obstructive and Central Sleep-Disordered Breathing in Older Men: Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study
Arch Intern Med, June 22, 2009; 169(12): 1147 - 1155.
[Abstract] [Full Text] [PDF]

Home page
 Journal of the American Dental AssociationHome page
A. H. Friedlander
Author's response
J Am Dent Assoc, May 1, 2009; 140(5): 514 - 515.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
A. Rosengren, P. J. Hauptman, G. Lappas, L. Olsson, L. Wilhelmsen, and K. Swedberg
Big men and atrial fibrillation: effects of body size and weight gain on risk of atrial fibrillation in men
Eur. Heart J., May 1, 2009; 30(9): 1113 - 1120.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. Collen, C. Lettieri, W. Kelly, and S. Roop
Clinical and Polysomnographic Predictors of Short-Term Continuous Positive Airway Pressure Compliance
Chest, March 1, 2009; 135(3): 704 - 709.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
E. J. Benjamin, P.-S. Chen, D. E. Bild, A. M. Mascette, C. M. Albert, A. Alonso, H. Calkins, S. J. Connolly, A. B. Curtis, D. Darbar, et al.
Prevention of Atrial Fibrillation: Report From a National Heart, Lung, and Blood Institute Workshop
Circulation, February 3, 2009; 119(4): 606 - 618.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Kisner, M. J. Wilhelm, M. S. Messerli, G. Zund, and M. Genoni
Reduced incidence of atrial fibrillation after cardiac surgery by continuous wireless monitoring of oxygen saturation on the normal ward and resultant oxygen therapy for hypoxia
Eur. J. Cardiothorac. Surg., January 1, 2009; 35(1): 111 - 115.
[Abstract] [Full Text] [PDF]

Home page
 EuropaceHome page
R.-B. Tang, J.-Z. Dong, X.-P. Liu, J.-P. Kang, S.-F. Ding, L. Wang, D.-Y. Long, R.-H. Yu, X.-H. Liu, S. Liu, et al.
Obstructive sleep apnoea risk profile and the risk of recurrence of atrial fibrillation after catheter ablation
Europace, January 1, 2009; 11(1): 100 - 105.
[Abstract] [Full Text] [PDF]

Home page
 ESC Textbook of Cardiovascular MedicineHome page
A. J. Camm, P. Kirchhof, G. Y.H. Lip, I. Savelieva, and S. Ernst
CHAPTER 29 Atrial Fibrillation
ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
T. S.M. Tsang, M. E. Barnes, Y. Miyasaka, S. S. Cha, K. R. Bailey, G. C. Verzosa, J. B. Seward, and B. J. Gersh
Obesity as a risk factor for the progression of paroxysmal to permanent atrial fibrillation: a longitudinal cohort study of 21 years
Eur. Heart J., September 2, 2008; 29(18): 2227 - 2233.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
Circulation, September 2, 2008; 118(10): 1080 - 1111.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
J. Am. Coll. Cardiol., August 19, 2008; 52(8): 686 - 717.
[Full Text] [PDF]

Home page
 EuropaceHome page
A. Baranchuk, C. S. Simpson, D. P. Redfearn, and M. Fitzpatrick
It's time to wake up!: sleep apnea and cardiac arrhythmias
Europace, June 1, 2008; 10(6): 666 - 667.
[Full Text] [PDF]

Home page
 EuropaceHome page
B. A. Schoonderwoerd, M. D. Smit, L. Pen, and I. C. Van Gelder
New risk factors for atrial fibrillation: causes of 'not-so-lone atrial fibrillation'
Europace, June 1, 2008; 10(6): 668 - 673.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
J. T. Nguyen and D. G. Benditt
Atrial Fibrillation Susceptibility in Metabolic Syndrome: Simply the Sum of Its Parts?
Circulation, March 11, 2008; 117(10): 1249 - 1251.
[Full Text] [PDF]

Home page
 ChestHome page
F. Lopez-Jimenez, F. H. Sert Kuniyoshi, A. Gami, and V. K. Somers
Obstructive Sleep Apnea: Implications for Cardiac and Vascular Disease
Chest, March 1, 2008; 133(3): 793 - 804.
[Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
J. M. Golbin, V. K. Somers, and S. M. Caples
Obstructive Sleep Apnea, Cardiovascular Disease, and Pulmonary Hypertension
Proceedings of the ATS, February 15, 2008; 5(2): 200 - 206.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
A. N. DeMaria, J. J. Bax, O. Ben-Yehuda, P. Clopton, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, J. D. Knoke, W. Y.W. Lew, J. A.C. Lima, et al.
Highlights of the year in JACC 2007.
J. Am. Coll. Cardiol., January 29, 2008; 51(4): 490 - 512.
[Full Text] [PDF]

Home page
 EuropaceHome page
F. G. Cosio, E. Aliot, G. L. Botto, H. Heidbuchel, C. J. Geller, P. Kirchhof, J.-C. De Haro, R. Frank, J. P. Villacastin, J. Vijgen, et al.
Delayed rhythm control of atrial fibrillation may be a cause of failure to prevent recurrences: reasons for change to active antiarrhythmic treatment at the time of the first detected episode
Europace, January 1, 2008; 10(1): 21 - 27.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. Romero-Corral, V. K. Somers, P. A. Pellikka, E. J. Olson, K. R. Bailey, J. Korinek, M. Orban, J. Sierra-Johnson, M. Kato, R. S. Amin, et al.
Decreased Right and Left Ventricular Myocardial Performance in Obstructive Sleep Apnea
Chest, December 1, 2007; 132(6): 1863 - 1870.
[Abstract] [Full Text] [PDF]

Home page
 Inj. Prev.Home page
K. M Pollack and L. J Cheskin
Obesity and workplace traumatic injury: does the science support the link?
Inj. Prev., October 1, 2007; 13(5): 297 - 302.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
S. M. Caples and V. K. Somers
CPAP treatment for obstructive sleep apnoea in heart failure: expectations unmet
Eur. Heart J., May 2, 2007; 28(10): 1184 - 1186.
[Full Text] [PDF]


 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement