{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:01Z","timestamp":1787018101036,"version":"build-2736575974"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Sleep fragmentation and sleep apnea are common in patients with atrial fibrillation (AF). We investigated the impact of radio\u2010frequency catheter ablation (RFCA) on sleep quality in patients with paroxysmal AF and the effect of a change in sleep quality on recurrence of AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Of 445 patients who underwent RFCA for paroxysmal AF between October 2007 and January 2017, we analyzed 225 patients who had a 24\u2010hour Holter test within 6\u00a0months before RFCA. Sleep quality was assessed by cardiopulmonary coupling analysis using 24\u2010hour Holter data. We compared cardiopulmonary coupling parameters (high\u2010frequency coupling, low\u2010frequency coupling, very\u2010low\u2010frequency coupling) before and after RFCA. Six months after RFCA, the high\u2010frequency coupling (marker of stable sleep) and very\u2010low\u2010frequency coupling (rapid eye movement\/wake marker) was significantly increased (29.84%\u201336.15%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001; and 26.20%\u201328.76%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.002, respectively) while low\u2010frequency coupling (unstable sleep marker) was decreased (41.25%\u201332.13%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). We divided patients into 3 tertiles according to sleep quality before RFCA, and the risk of AF recurrence in each group was compared. The second tertile was used as a reference; patients with unstable sleep (Tertile 3) had a significantly lower risk of AF recurrence (hazard ratio [HR], 0.32; 95% CI, 0.12\u20130.83 for high\u2010frequency coupling; and HR, 0.22; 95% CI, 0.09\u20130.58 for low\u2010frequency coupling).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Sleep quality improved after RFCA in patients with paroxysmal AF. The recurrence rate was significantly lower in patients who had unstable sleep before RFCA. These results suggest that RFCA can influence sleep quality, and sleep quality assessment before RFCA may provide a risk marker for recurrence after RFCA in patients with paroxysmal AF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.017016","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T05:06:18Z","timestamp":1606367178000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of Catheter Ablation on Sleep Quality and Relationship Between Sleep Stability and Recurrence of Paroxysmal Atrial Fibrillation After Successful Ablation: 24\u2010Hour Holter\u2010Based Cardiopulmonary Coupling Analysis"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6939-5958","authenticated-orcid":false,"given":"Woohyeun","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine College of Medicine Hanyang University Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5096-4428","authenticated-orcid":false,"given":"Jin Oh","family":"Na","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Korea University Guro Hospital Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine Department of Medicine Beth Israel Deaconess Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Young","family":"Jang","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Catholic University of Korea St. Vincent Hospital Suwon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5187-8310","authenticated-orcid":false,"given":"Dong 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