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Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists

Faulx, M. D. (author)
Mehra, R. (author)
Geovanini, G. R. (author)
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Ando, S. (author)
Arzt, M. (author)
Drager, L. (author)
Fu, Michael, 1963 (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
Hoyos, C. (author)
Hai, J. (author)
Hwang, J. J. (author)
Karaoguz, R. (author)
Kimoff, J. (author)
Lee, P. L. (author)
Mediano, O. (author)
Patel, S. R. (author)
Peker, Y. (author)
Pepin, J. L. (author)
Sanchez-De-la-Torre, M. (author)
Series, F. (author)
Stadler, S. (author)
Strollo, P. (author)
Tahrani, A. A. (author)
Thunstrom, E. (author)
Yamauchi, M. (author)
Redline, S. (author)
Phillips, C. L. (author)
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 (creator_code:org_t)
Elsevier BV, 2022
2022
English.
In: International journal of cardiology: Heart and Vasculature (IJCHA). - : Elsevier BV. - 2352-9067. ; 42
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background: Among international cardiologists it is unclear whether equipoise exists regarding the benefit of diagnosing and managing obstructive sleep apnea (OSA) to improve atrial fibrillation (AF) outcomes and whether clinical practice and equipoise are linked. Methods: Between January 2019 and June 2020 we distributed a web-based 12-question survey regarding OSA and AF management to practicing cardiologists in 16 countries. Results: The United States, Japan, Sweden, and Turkey accounted for two-thirds of responses. 863 cardiologists responded; half were general cardiologists, a quarter electrophysiologists. Responses regarding treating OSA with CPAP to improve AF endpoints were mixed. 33% of respondents referred AF patients for OSA screening. OSA was diagnosed in 48% of referred patients and continuous positive airway pressure (CPAP) was prescribed for 59% of them. Nearly 70% of respondents believed randomized controlled trials (RCTs) of OSA treatment in AF patients were necessary and indicated willingness to contribute to such trials. Conclusions: There was no clinical equipoise among surveyed cardiologists; a majority expressed certainty that combined OSA and AF treatment is superior to AF treatment alone for improving AF outcomes. However, a minority of surveyed cardiologists referred AF patients for OSA testing, and while half of screened AF patients had OSA, CPAP was prescribed in little more than half of them, reflecting the view that better clinical trial evidence is needed to support this practice. Our results underscore the need for larger, multi-national prospective studies of OSA treatment and AF outcomes to inform more uniform society guideline recommendations.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Sleep apnea
Atrial fibrillation
Survey
International
Clinical
equipoise
heart rhythm society
positive airway pressure
disease
association
guidelines
epidemiology
prevalence
prevention
Cardiovascular System & Cardiology

Publication and Content Type

ref (subject category)
art (subject category)

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