0962 Prevalence of Obstructive Sleep Apnea Among Consecutive Patients with Atrial Fibrillation Using WatchPAT Home Sleep Testing

Abstract Introduction Obstructive sleep apnea (OSA) is highly prevalent in symptomatic atrial fibrillation (AF) patients undergoing ablation and may reduce the efficacy of rhythm control strategies in patients with AF. However, consecutive sleep testing has not been confirmed in a larger general AF population and less is known regarding the prevalence of OSA by subtype of AF. Methods In this pragmatic, phase IV prospective cohort study, we performed first-time testing for sleep apnea on consecutively enrolled ambulatory AF patients from outpatient clinics using a home sleep test. The primary outcome of our study was the prevalence of undiagnosed mild or moderate/severe OSA in the AF cohort. Results We performed sleep testing in 180 AF patients (126 paroxysmal (70%) and 54 persistent or long standing persistent (30%)). Among enrolled patients, 40 (31.3%) had undergone AF catheter ablation, 35 (27.3%) had undergone a previous cardioversion, and 51 (40.0%) had undergone no prior AF related procedure. The prevalence of undiagnosed OSA was 83.3% with 47.2% meeting moderate or severe criteria. Patients with persistent/longstanding persistent AF demonstrated the highest rates of OSA with 52 (96.3%) testing positive for OSA and with 35 (64.2%) demonstrating moderate/severe OSA. Conclusion Consecutive sleep testing in ambulatory AF patients enrolled from outpatient clinics, regardless of AF symptom status or AF treatment strategy, demonstrated a high prevalence of undiagnosed OSA with more severe OSA among those with persistent AF compared to non-paroxysmal AF. Our study demonstrates higher prevalence of OSA among those with persistent AF compared to paroxysmal AF as well. Widely used clinical prediction instruments cannot effectively be used to guide sleep testing decisions in AF patients and our results suggest routine sleep apnea testing should be strongly considered in the comprehensive evaluation of all AF patients, but particularly those with persistent AF. Support (if any) This study was sponsored by the Zoll Medical Corporation. The study was performed at the Brigham and Women’s Hospital AF Center of Excellence that is funded partly by the Brigham Research Institute Director’s Transformative Award #2019A018348.