ASSOCIATION BETWEEN OBSTRUCTIVE SLEEP APNEA SYNDROME AND ATRIAL REMODELING IN PATIENTS WITH ATRIAL FIBRILLATION: A SYSTEMATIC REVIEW

Authors

  • Rodolfo de Oliveira Medeiros Author
  • Mara Flávia Mamédio Avallone Author
  • Cristiano Machado Galhardi Author
  • Carlos Eduardo Bueno Author
  • Piero Biteli Author
  • Natália Cabrera de Souza Fujikawa Author
  • Maria Fernanda Alberto Farina Abbonizio Author
  • Percyleine Pelegrine Herculiani Author
  • Fábio Augusto Freiria Barbosa Author
  • Wilson Bernardo Silva Author
  • Joyce Gonçalves Berteli Author
  • Milena Cristina Campassi Author
  • Lorrana de Sousa Landim Xavier Author
  • Luiz Fernando Fregatto Author
  • Laura Terenciani Campoy Author

DOI:

https://doi.org/10.56238/arev8n2-061

Keywords:

Atrial Fibrillation, Obstructive Sleep Apnea, Atrial Remodeling, Left Atrium

Abstract

Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia, and its pathophysiology is closely linked to atrial remodeling, characterized by structural and electrophysiological alterations of the left atrium. Obstructive sleep apnea syndrome (OSAS) has been increasingly recognized as an important risk factor and potentially modifiable condition associated with AF. Contemporary guidelines emphasize the relevance of OSAS in the integrated management of atrial fibrillation. The aim of this systematic review was to evaluate the association between obstructive sleep apnea syndrome and atrial remodeling in patients with atrial fibrillation. This systematic review was conducted in accordance with PRISMA 2020 recommendations, with searches performed in PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library. The included studies demonstrated a consistent association between OSAS and alterations in the atrial substrate, particularly evidenced by electroanatomical remodeling, reduced atrial voltage, increased low-voltage areas, and structural and functional changes of the left atrium. In conclusion, OSAS is associated with a greater degree of atrial remodeling in patients with atrial fibrillation, reinforcing its role as a clinically relevant and potentially modifiable factor in arrhythmia management.

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References

Brasca, F. M. A., Linz, D., Hsu, L. F., & Arias, M. A. (2024). Obstructive sleep apnoea and atrial fibrillation: Are we on the right track? Open Heart, 11(2), e002859. https://openheart.bmj.com/content/11/2/e002859

Dimitri, H., Ng, M., Brooks, A. G., Kalman, J. M., & Sanders, P. (2012). Atrial remodeling in obstructive sleep apnea: Implications for atrial fibrillation. Heart Rhythm, 9(3), 321–327. https://doi.org/10.1016/j.hrthm.2011.10.017

Hindricks, G., Potpara, T., Dagres, N., Arbelo, E., Bax, J. J., Blomström-Lundqvist, C., … Watkins, C. L. (2021). 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the EACTS. European Heart Journal, 42(5), 373–498. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Atrial-Fibrillation

Hunt, T. E. F., Lip, G. Y. H., Kotecha, D., Lane, D. A., Raghavan, A., Townend, J. N., … Kadhim, K. (2024). Cardiac remodelling in patients with atrial fibrillation and obstructive sleep apnoea: A randomised controlled trial. Open Heart, 11(2), e002718. https://pubmed.ncbi.nlm.nih.gov/39477342/

Kim, S. M., Lee, J. H., Kim, S. Y., Kim, M. J., Park, S. J., Park, K. M., & On, Y. K. (2012). Impact of obstructive sleep apnea on left atrial functional changes in obese subjects: Assessment by two-dimensional and strain echocardiography. Journal of Cardiology, 60(2), 108–114. https://www.journal-of-cardiology.com/article/S0914-5087(12)00133-5/fulltext

Oliveira, W., Campos, O., Bezerra, C. G., Franchini Ramires, J. A., & Mathias, W. (2008). Left atrial volume and function in patients with obstructive sleep apnea assessed by real-time three-dimensional echocardiography. Journal of the American Society of Echocardiography, 21(12), 1355–1361. https://pubmed.ncbi.nlm.nih.gov/18930630/

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://www.bmj.com/content/372/bmj.n71

Shukla, A., Avram, R., Malik, R., Sengupta, P. P., Steinberg, J. S., & Kowey, P. R. (2015). Effect of obstructive sleep apnea treatment on atrial fibrillation recurrence: A meta-analysis. JACC: Clinical Electrophysiology, 1(1–2), 41–51. https://pubmed.ncbi.nlm.nih.gov/29759338/

Stang, A. (2010). Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. European Journal of Epidemiology, 25(9), 603–605. https://doi.org/10.1007/s10654-010-9491-z

Takada, Y., Okada, M., Kurita, T., Inoue, K., Ueda, T., Yamashita, S., … Shimizu, W. (2024). Intermittent hypoxia by obstructive sleep apnea is significantly associated with electro-anatomical remodeling of the left atrium preceding structural remodeling in patients with atrial fibrillation. International Journal of Cardiology: Heart & Vasculature, 54, 101490. https://pubmed.ncbi.nlm.nih.gov/39234287/

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Published

2026-02-11

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Articles

How to Cite

MEDEIROS, Rodolfo de Oliveira et al. ASSOCIATION BETWEEN OBSTRUCTIVE SLEEP APNEA SYNDROME AND ATRIAL REMODELING IN PATIENTS WITH ATRIAL FIBRILLATION: A SYSTEMATIC REVIEW. ARACÊ , [S. l.], v. 8, n. 2, p. e12161, 2026. DOI: 10.56238/arev8n2-061. Disponível em: https://periodicos.newsciencepubl.com/arace/article/view/12161. Acesso em: 17 feb. 2026.