The degree of ischemia-reperfusion as a possible risk factor for the development of atrial fibrillation in patients with obstructive sleep apnea syndrome

Abstract

Objective: the purpose of this study was to identify possible factors for the occurrence of atrial fibrillation (AF) in patients with obstructive sleep apnea syndrome (OSA). Materials and methods: the retrospective study included 50 patients (38 men and 12 women, average age 53 (13) years) admitted to Sleep Medicine Center of University clinic of  Lomonosov State University with complaints of snoring and stop of breathig during sleep and who underwent a polysomnographic study. The study included only patients with moderate and severe OSA. For all patients included in the study, the presence of comorbidities was assessed: arterial hypertension (HTN), type 2 diabetes mellitus (DM), coronary heart disease (CHD) and restless legs syndrome (RLS). Results: 11 patients had a history of atrial fibrillation and/or during polysomnography. When assessing heart rhythm during a polysomnographic study, 5 patients (10%) had AF, of which 1 patient had not previously reported the presence of arrhythmia. A predictive model was developed to estimate the probability of AF (atrium fibrillation) conditioning on age, average desaturation, % using binary logistic regression. The resulting regression model is statistically significant (p < 0.001). Based on the value of Nagelkerke R², the model explains 50.6% of the observed AF variance. 1 increase of age is associated with 1.211 times increase in AF odds. 1 increase of average desaturation, % is associated with 1.448 times increase in AF odds. Conclusions: it was shown for the first time that, along with such a well-known risk factor for AF as age, parameters of respiratory disorders during sleep, namely, average desaturation, can play a role in the development of AF through the mechanisms of myocardial ischemia-reperfusion. Average desaturation, reflecting the degree of ischemia-reperfusion, may become a risk factor for the development of AF.