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Atrial fibrillation and obstructive sleep aponea

Dr Robert Anderson, Institution: Melbourne Health

2017 Health Professional Scholarship

Years funded: 2018-2020

Atrial fibrillation (AF) is the commonest sustained cardiac arrhythmia in humans and has been estimated to affect up to 33.5 million people in the United States of America alone.
Its exponential growth in global prevalence, carries profound implications for community health and sustainability of existing health structures. Similarly, obstructive sleep apnea (OSA) has become increasingly diagnosed. Alarmingly, a recent study suggests that up to 23% of women and 49% men have moderate to severe OSA. Epidemiological data have consistently demonstrated an independent association between the two conditions.
Many of the mechanistic perturbations that impact the AF substrate in OSA can be substantially attenuated by effective treatment with continuous positive airway pressure (CPAP).
An association between OSA treatment and improved AF control has been observed. However, the precision and generalisability of these findings are unclear in view of the data’s observational nature.
Although OSA management is emerging as a critical component of AF treatment, there are yet no randomised studies confirming its importance. This is particularly important in an era when catheter ablation is increasingly utilised as a strategy for AF control.
Dr Robert Anderson will conduct a prospective multicentre randomized study to evaluate the impact of OSA treatment with CPAP on: (i) the AF atrial electrical and structural substrate and (ii) long term (2 year) maintenance of sinus rhythm following catheter ablation.

This project is co-funded with NHMRC - National Health and Medical Research Council.

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