{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:05:12Z","timestamp":1790316312221,"version":"4.1.0"},"reference-count":87,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Obstructive sleep apnea (OSA) is a highly prevalent disorder with a growing incidence worldwide that closely mirrors the global obesity epidemic. OSA is associated with enormous healthcare costs in addition to significant morbidity and mortality. Much of the morbidity and mortality related to OSA can be attributed to an increased burden of cardiovascular disease, including cardiac rhythm disorders. Awareness of the relationship between OSA and rhythm disorders is variable among physicians, a fact that can influence patient care, since the presence of OSA can influence the incidence, prevalence, and successful treatment of multiple rhythm disorders. Herein, we provide a review of this topic that is intentionally broad in scope, covering the relationship between OSA and rhythm disorders from epidemiology and pathophysiology to diagnosis and management, with a particular focus on the recognition of undiagnosed OSA in the general clinical population and the intimate relationship between OSA and atrial fibrillation.<\/jats:p>","DOI":"10.3390\/jcm10173785","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T22:12:22Z","timestamp":1629843142000},"page":"3785","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Obstructive Sleep Apnea and Cardiac Arrhythmias: A Contemporary Review"],"prefix":"10.3390","volume":"10","author":[{"given":"Balint","family":"Laczay","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Faulx","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e010440","DOI":"10.1161\/JAHA.118.010440","article-title":"Obstructive Sleep Apnea in Cardiovascular Disease: A Review of the Literature and Proposed Multidisciplinary Clinical Management Strategy","volume":"8","author":"Tietjens","year":"2019","journal-title":"J. Am. Hear. Assoc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.smrv.2016.07.002","article-title":"Prevalence of obstructive sleep apnea in the general population: A systematic review","volume":"34","author":"Senaratna","year":"2016","journal-title":"Sleep Med. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Guillot, M., Sforza, E., Crawford, E.A., Maudoux, D., Martin, M.S., Barth\u00e9l\u00e9my, J.-C., and Roche, F. (2013). Association between severe obstructive sleep apnea and incident arterial hypertension in the older people population. Sleep Med., 838\u2013842.","DOI":"10.1016\/j.sleep.2013.05.002"},{"key":"ref_4","first-page":"1","article-title":"Obstructive Sleep Apnea and Acute Coronary Syndromes: Etiology, Risk, and Management","volume":"16","author":"Acharjee","year":"2014","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_5","first-page":"52","article-title":"Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: The sleep heart health study","volume":"22","author":"Gottlieb","year":"2010","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"396","DOI":"10.21037\/cdt.2020.03.02","article-title":"Obstructive sleep apnea versus central sleep apnea: Prognosis in systolic heart failure","volume":"10","author":"Hetland","year":"2020","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.sleep.2012.08.021","article-title":"The association between atrial fibrillation and stroke in patients with obstructive sleep apnea: A population-based case-control study","volume":"14","author":"Mansukhani","year":"2013","journal-title":"Sleep Med."},{"key":"ref_8","first-page":"e9992","article-title":"Obstructive Sleep Apnea: Risk Factor for Arrhythmias, Conduction Disorders, and Cardiac Arrest","volume":"12","author":"Acharya","year":"2020","journal-title":"Cureus"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1080\/17476348.2019.1604226","article-title":"Diagnosis and management of central sleep apnea syndrome","volume":"13","author":"Baillieul","year":"2019","journal-title":"Expert Rev. Respir. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Yu, L., Li, X., Huang, B., Zhou, X., Wang, M., Zhou, L., Meng, G., Wang, Y., Wang, Z., and Deng, J. (2017). Atrial Fibrillation in Acute Obstructive Sleep Apnea: Autonomic Nervous Mechanism and Modulation. J. Am. Hear. Assoc., 6.","DOI":"10.1161\/JAHA.117.006264"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Chahal, A.A., Somers, V.K., Chan, W., Coutts, S.B., Hanly, P., Jiang, N., Zhou, A., Prasad, B., Zhou, L., and Doumit, J. (2016). Ion Channel Remodeling\u2014A Potential Mechanism Linking Sleep Apnea and Sudden Cardiac Death. J. Am. Hear. Assoc., 5.","DOI":"10.1161\/JAHA.116.004195"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1093\/aje\/kws342","article-title":"Increased Prevalence of Sleep-Disordered Breathing in Adults","volume":"177","author":"Peppard","year":"2013","journal-title":"Am. J. Epidemiology"},{"key":"ref_13","first-page":"52","article-title":"Obesity, obstructive sleep apnea and type diabetes mellitus: Epidemiology and pathophysiologic insights","volume":"2","author":"Jehan","year":"2018","journal-title":"Sleep Med. Disord. Int. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"261","DOI":"10.5664\/jcsm.27191","article-title":"Obstructive Sleep Apnea and Cardiovascular Disease: Role of the Metabolic Syndrome and Its Components","volume":"4","author":"Zizi","year":"2008","journal-title":"J. Clin. Sleep Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1378\/chest.15-0903","article-title":"STOP-Bang Questionnaire: A Practical Approach to Screen for Obstructive Sleep Apnea","volume":"149","author":"Chung","year":"2016","journal-title":"Chest"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.smrv.2016.10.004","article-title":"Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: A bivariate meta-analysis","volume":"6","author":"Chiu","year":"2017","journal-title":"Sleep Med. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Nagappa, M., Liao, P., Wong, J., Auckley, D., Ramachandran, S.K., Memtsoudis, S.G., Mokhlesi, B., and Chung, F. (2015). Validation of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea among Different Populations: A Systematic Review and Meta-Analysis. PLOS ONE, 10.","DOI":"10.1371\/journal.pone.0143697"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1378\/chest.103.1.30","article-title":"Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale","volume":"103","author":"Johns","year":"1993","journal-title":"Chest"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.5664\/jcsm.6836","article-title":"Dissociation of Objective and Subjective Daytime Sleepiness and Biomarkers of Systemic Inflammation in Sleep-Disordered Breathing and Systolic Heart Failure","volume":"13","author":"Mehra","year":"2017","journal-title":"J. Clin. Sleep Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"79","DOI":"10.5664\/jcsm.8830","article-title":"The impact of the COVID-19 pandemic on sleep medicine practices","volume":"7","author":"Johnson","year":"2021","journal-title":"J. Clin. Sleep Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1513\/AnnalsATS.202009-1202OC","article-title":"Association of Nocturnal Hypoxemia and Pulse Rate Variability with Incident Atrial Fibrillation in Patients Investigated for Obstructive Sleep Apnea","volume":"18","author":"Blanchard","year":"2021","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.5664\/jcsm.7806","article-title":"Severity of Desaturations Reflects OSA-Related Daytime Sleepiness Better Than AHI","volume":"15","author":"Kainulainen","year":"2019","journal-title":"J. Clin. Sleep Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Xie, J., Kuniyoshi, F.H.S., Covassin, N., Singh, P., Gami, A.S., Wang, S., Chahal, C.A.A., Wei, Y., and Somers, V.K. (2016). Nocturnal Hypoxemia Due to Obstructive Sleep Apnea Is an Independent Predictor of Poor Prognosis After Myocardial Infarction. J. Am. Hear. Assoc., 5.","DOI":"10.1161\/JAHA.115.003162"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.chest.2016.09.014","article-title":"OSA. Cardiac Arrhythmogenesis: Mechanistic Insights","volume":"51","author":"May","year":"2017","journal-title":"Chest"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.pcad.2008.06.002","article-title":"Sleep-Disordered Breathing: Autonomic Mechanisms and Arrhythmias","volume":"51","author":"Leung","year":"2009","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1378\/chest.06-2703","article-title":"Obstructive sleep apnea, hypertension, and their interaction on arterial stiffness and heart remodeling","volume":"31","author":"Drager","year":"2007","journal-title":"Chest"},{"key":"ref_27","first-page":"2169","article-title":"Association Between Treated and Untreated Obstructive Sleep Apnea and Risk of Hypertension","volume":"07","author":"Marin","year":"2012","journal-title":"JAMA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1164\/ajrccm.163.1.2001008","article-title":"Sleep-disordered Breathing and Cardiovascular Disease","volume":"163","author":"Shahar","year":"2001","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_29","first-page":"e750","article-title":"Lifestyle and Risk Factor Modification for Reduction of Atrial Fibrillation: A Scientific Statement From the American Heart Association","volume":"41","author":"Chung","year":"2020","journal-title":"Circulation"},{"key":"ref_30","first-page":"28","article-title":"Prevalence of obstructive sleep apnea syndrome in patients with sick sinus syndrome","volume":"9","author":"Almor","year":"2006","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1378\/chest.106.2.466","article-title":"Cardiac arrhythmias, snoring, and sleep apnea","volume":"106","author":"Hoffstein","year":"1994","journal-title":"Chest"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1056\/NEJMoa041832","article-title":"Day-night pattern of sudden death in obstructive sleep apnea","volume":"52","author":"Gami","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_33","unstructured":"Mann, D., Zipes, D., Libby, P., and Bonow, R. (2015). Braunwald\u2019s Heart Disease: A Textbook of Cardiovascular Medicine, Elsevier\/Saunders. [11th ed.]."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s10840-018-0423-2","article-title":"Cardiac automaticity: Basic concepts and clinical observations","volume":"52","author":"Vetulli","year":"2018","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1016\/j.hrthm.2011.03.053","article-title":"Negative tracheal pressure during obstructive respiratory events promotes atrial fibrillation by vagal activation","volume":"8","author":"Linz","year":"2011","journal-title":"Hear. Rhythm."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Chadda, K.R., Fazmin, I.T., Ahmad, S., Valli, H., E Edling, C., Huang, C.L.-H., and Jeevaratnam, K. (2018). Arrhythmogenic mechanisms of obstructive sleep apnea in heart failure patients. Sleep, 41.","DOI":"10.1093\/sleep\/zsy136"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.autneu.2013.03.014","article-title":"Increase in vulnerability of atrial fibrillation in an acute intermittent hypoxia model: Importance of autonomic imbalance","volume":"177","author":"Lu","year":"2013","journal-title":"Auton. Neurosci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.joa.2015.11.003","article-title":"Mechanisms of cardiac arrhythmias","volume":"32","author":"Tse","year":"2015","journal-title":"J. Arrhythmia"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jsmc.2016.10.004","article-title":"Management of Sleep Apnea Syndromes in Heart Failure","volume":"12","author":"Selim","year":"2017","journal-title":"Sleep Med. Clin."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/j.amjcard.2008.07.050","article-title":"Dynamic Changes of Left Ventricular Performance and Left Atrial Volume Induced by the Mueller Maneuver in Healthy Young Adults and Implications for Obstructive Sleep Apnea, Atrial Fibrillation, and Heart Failure","volume":"102","author":"Orban","year":"2008","journal-title":"Am. J. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1378\/chest.121.2.422","article-title":"Severe Obstructive Sleep Apnea Is Associated With Left Ventricular Diastolic Dysfunction","volume":"121","author":"Fung","year":"2002","journal-title":"Chest"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1152\/jappl.1995.79.2.455","article-title":"Effect of negative intrathoracic pressure on left ventricular pressure dynamics and relaxation","volume":"79","author":"Virolainen","year":"1995","journal-title":"J. Appl. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/j.ehj.2004.04.017","article-title":"Severe bradyarrhythmias in patients with sleep apnoea: The effect of continuous positive airway pressure treatment: A long-term evaluation using an insertable loop recorder","volume":"5","author":"Simantirakis","year":"2004","journal-title":"Eur. Heart J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1164\/rccm.200509-1442OC","article-title":"Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study","volume":"73","author":"Mehra","year":"2006","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/0002-9149(83)90013-9","article-title":"Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome","volume":"52","author":"Guilleminault","year":"1983","journal-title":"Am. J. Cardiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1136\/thx.53.2008.S29","article-title":"Heart block in patients with sleep apnoea","volume":"53","author":"Becker","year":"1998","journal-title":"Thorax"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/0002-9343(77)90272-8","article-title":"Sleep-induced apnea syndrome: Prevalence of cardiac arrhythmias and their reversal after tracheostomy","volume":"63","author":"Tilkian","year":"1977","journal-title":"Am. J. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.autneu.2012.02.005","article-title":"Baroreflex modulation during sleep and in obstructive sleep apnea syndrome","volume":"169","author":"Cortelli","year":"2012","journal-title":"Auton. Neurosci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1172\/JCI110568","article-title":"Bradycardia during sleep apnea. Characteristics and mechanism","volume":"69","author":"Zwillich","year":"1982","journal-title":"J. Clin. Investig."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1113\/jphysiol.1958.sp006092","article-title":"The effects of stimulation of the carotid body chemoreceptors on heart rate in the dog","volume":"144","author":"Daly","year":"1958","journal-title":"J. Physiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1161\/CIRCULATIONAHA.106.659706","article-title":"High Prevalence of Sleep Apnea Syndrome in Patients With Long-Term Pacing","volume":"115","author":"Garrigue","year":"2007","journal-title":"Circulation"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Dimitri, H., Ng, M., Brooks, A.G., Kuklik, P., Stiles, M.K., Lau, D.H., Antic, N., Thornton, A., Saint, D.A., and McEvoy, D. (2012). Atrial remodeling in obstructive sleep apnea: Implications for atrial fibrillation. Heart Rhythm, 321\u2013327.","DOI":"10.1016\/j.hrthm.2011.10.017"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1161\/CIRCULATIONAHA.113.005119","article-title":"Worldwide epidemiology of atrial fibrillation: A Global Burden of Disease010 Study","volume":"29","author":"Chugh","year":"2014","journal-title":"Circulation"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1056\/NEJM199809033391003","article-title":"Spontaneous Initiation of Atrial Fibrillation by Ectopic Beats Originating in the Pulmonary Veins","volume":"339","author":"Shah","year":"1998","journal-title":"New Engl. J. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1161\/CIRCRESAHA.116.310489","article-title":"Controversies about atrial fibrillation mechanisms: Aiming for order in chaos and whether it matters","volume":"20","author":"Nattel","year":"2017","journal-title":"Circ. Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/j.1540-8167.2010.01876.x","article-title":"Atrial Fibrosis Helps Select the Appropriate Patient and Strategy in Catheter Ablation of Atrial Fibrillation: A DE-MRI Guided Approach","volume":"22","author":"Akoum","year":"2010","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2731","DOI":"10.1093\/eurheartj\/eht194","article-title":"Human atrial fibrillation substrate: Towards a specific fibrotic atrial cardiomyopathy","volume":"4","author":"Kottkamp","year":"2013","journal-title":"Eur. heart J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.hrthm.2016.09.001","article-title":"Ganglionated plexus ablation for atrial fibrillation: Just because we can, does that mean we should?","volume":"14","author":"Buckley","year":"2017","journal-title":"Hear. Rhythm."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1161\/01.CIR.0000136587.68725.8E","article-title":"Association of Atrial Fibrillation and Obstructive Sleep Apnea","volume":"110","author":"Gami","year":"2004","journal-title":"Circulation"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.sleep.2007.12.007","article-title":"Sleep-disordered breathing and chronic atrial fibrillation","volume":"10","author":"Braga","year":"2009","journal-title":"Sleep Med."},{"key":"ref_61","first-page":"662","article-title":"Prevalence of sleep disordered breathing in paroxysmal and persistent atrial fibrillation patients with normal left ventricular function","volume":"9","author":"Stevenson","year":"2008","journal-title":"Eur. Heart J."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"180","DOI":"10.15420\/aer.2019.35.2","article-title":"Relationship Between Obstructive Sleep Apnoea and AF","volume":"8","author":"Shantha","year":"2019","journal-title":"Arrhythmia Electrophysiol. Rev."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2013","DOI":"10.1016\/j.jacc.2014.05.077","article-title":"Atrial Fibrillation Promotion With Long-Term Repetitive Obstructive Sleep Apnea in a Rat Model","volume":"64","author":"Iwasaki","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1465-9921-15-54","article-title":"Atrial fibrosis in a chronic murine model of obstructive sleep apnea: Mechanisms and prevention by mesenchymal stem cells","volume":"15","author":"Ramos","year":"2014","journal-title":"Respir. Res."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Anter, E., Biase, L.D., Valdes, F.M.C., Gianni, C., Mohanty, S., Tschabrunn, C.M., Gonzalez, J.F.V., Leshem, E., Buxton, A.E., and Kulbak, G. (2017). Atrial Substrate and Triggers of Paroxysmal Atrial Fibrillation in Patients With Obstructive Sleep Apnea. Circ. Arrhythmia Electrophysiol., e005407.","DOI":"10.1161\/CIRCEP.117.005407"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1016\/j.jacc.2009.06.038","article-title":"Triggering of Nocturnal Arrhythmias by Sleep-Disordered Breathing Events","volume":"54","author":"Monahan","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1016\/j.hrthm.2010.03.020","article-title":"Atrial electrophysiology is altered by acute hypercapnia but not hypoxemia: Implications for promotion of atrial fibrillation in pulmonary disease and sleep apnea","volume":"7","author":"Stevenson","year":"2010","journal-title":"Hear. Rhythm."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1111\/pace.13763","article-title":"Influence of risk factors in the ESC-EHRA EORP atrial fibrillation ablation long-term registry","volume":"42","author":"Trines","year":"2019","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2589","DOI":"10.1161\/01.CIR.0000068337.25994.21","article-title":"Obstructive Sleep Apnea and the Recurrence of Atrial Fibrillation","volume":"107","author":"Kanagala","year":"2003","journal-title":"Circulation"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"f337","DOI":"10.1093\/europace\/eux248","article-title":"Obstructive sleep apnea is associated with increased rotor burden in patients undergoing focal impulse and rotor modification guided atrial fibrillation ablation","volume":"20","author":"Friedman","year":"2017","journal-title":"Europace"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/s11897-013-0171-7","article-title":"Arrhythmia Risk Associated with Sleep Disordered Breathing in Chronic Heart Failure","volume":"11","author":"Mehra","year":"2013","journal-title":"Curr. Hear. Fail. Rep."},{"key":"ref_72","first-page":"30","article-title":"Obstructive sleep apnea increases heart rhythm disorders and worsens subsequent outcomes in elderly patients with subacute myocardial infarction","volume":"8","author":"Wang","year":"2021","journal-title":"J. Geriatr. Cardiol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"577248","DOI":"10.3389\/fcvm.2020.577248","article-title":"Primary Prevention Implantable Cardiac Defibrillators: A Townsville District Perspective","volume":"7","author":"Engstrom","year":"2020","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Yeghiazarians, Y., Jneid, H., Tietjens, J.R., Redline, S., Brown, D.L., El-Sherif, N., Mehra, R., Bozkurt, B., Ndumele, C.E., and Somers, V.K. (2021). Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation.","DOI":"10.1161\/CIR.0000000000000988"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e007626","DOI":"10.1161\/CIRCEP.119.007626","article-title":"Impact of Bariatric Surgery on Atrial Fibrillation Type","volume":"13","author":"Donnellan","year":"2020","journal-title":"Circ. Arrhythmia Electrophysiol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.ahj.2014.12.024","article-title":"Impact of obstructive sleep apnea and continuous positive airway pressure therapy on outcomes in patients with atrial fibrillation\u2014Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF)","volume":"169","author":"Holmqvist","year":"2015","journal-title":"Am. Hear. J."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1007\/s00380-013-0394-2","article-title":"Suppressive effects of adaptive servo-ventilation on ventricular premature complexes with attenuation of sympathetic nervous activity in heart failure patients with sleep-disordered breathing","volume":"29","author":"Iwaya","year":"2013","journal-title":"Hear. Vessel."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.sleep.2018.02.013","article-title":"Treating obstructive sleep apnea with continuous positive airway pressure reduces risk of recurrent atrial fibrillation after catheter ablation: A metaanalysis","volume":"46","author":"Deng","year":"2018","journal-title":"Sleep Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.hrthm.2018.07.027","article-title":"Adaptive servo-ventilation reduces atrial fibrillation burden in patients with heart failure and sleep apnea","volume":"16","author":"Piccini","year":"2019","journal-title":"Hear. Rhythm."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Traaen, G.M., Aaker\u00f8y, L., Hunt, T.-E., \u00d8verland, B., Bendz, C., Sande, L., Akhus, S., Fagerland, M.W., Steinshamn, S., and Anfinsen, O.-G. (2021). Effect of Continuous Positive Airway Pressure on Arrhythmia in Atrial Fibrillation and Sleep Apnea: A Randomized Controlled Trial. Am. J. Respir. Crit. Care Med.","DOI":"10.1183\/13993003.congress-2020.2504"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.ijcard.2018.11.100","article-title":"The impact of continuous positive airway pressure treatment on the recurrence of atrial fibrillation post cardioversion: A randomized controlled trial","volume":"278","author":"Caples","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1080\/17476348.2019.1575204","article-title":"Obstructive sleep apnoea and comorbidity\u2014An overview of the association and impact of continuous positive airway pressure therapy","volume":"13","author":"McNicholas","year":"2019","journal-title":"Expert Rev. Respir. Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/j.1365-2869.2008.00659.x","article-title":"Daytime sleepiness and neural cardiac modulation in sleep-related breathing disorders","volume":"17","author":"Lombardi","year":"2008","journal-title":"J. Sleep Res."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1093\/sleep\/29.12.1531","article-title":"Sleepiness in obstructive sleep apnea: A harbinger of impaired cardiac function?","volume":"29","author":"Choi","year":"2006","journal-title":"Sleep"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1056\/NEJMoa1606599","article-title":"CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea","volume":"375","author":"McEvoy","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"McEvoy, R.D., S\u00e1nchez-De-La-Torre, M., Peker, Y., Anderson, C.S., Redline, S., and Barbe, F. (2021). Randomized clinical trials of cardiovascular disease in obstructive sleep apnea: Understanding and overcoming bias. Sleep, 44.","DOI":"10.1093\/sleep\/zsab019"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1111\/jce.14607","article-title":"Impact of risk-factor modification on arrhythmia recurrence among morbidly obese patients undergoing atrial fibrillation ablation","volume":"31","author":"Donnellan","year":"2020","journal-title":"J. Cardiovasc. Electrophysiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/17\/3785\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:50:46Z","timestamp":1760165446000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/17\/3785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,24]]},"references-count":87,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["jcm10173785"],"URL":"https:\/\/doi.org\/10.3390\/jcm10173785","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,24]]}}}