Prevalence and Factors Associated With Atrial Fibrillation in Elderly Patients With Obstructive Sleep Apnea

Abstract Purpose: This study sought to identify the prevalence and factors associated with atrial fibrillation (AF) in elderly patients with obstructive sleep apnea (OSA) in China. Methods: Between January 2015 and October 2017, we recruited 1285 elderly patients with OSA who underwent overnight polysomnography at sleep centers of multiple hospitals. They were assessed using 12-lead ECG or 24-hour dynamic ECG, and their baseline demographics, clinical characteristics, sleep parameters, and medical history were determined. Binary logistic regression analysis was used to investigate the factors related to AF in these elderly patients. Results: The clinician classified 122 (9.5%) patients as having AF. The prevalence of AF significantly increased with age (p＜0.05) but did not significantly differ between the mild, moderate, and severe OSA groups. Additionally, the prevalence of paroxysmal AF was 7.2% among the overall study population, and it increased with OSA severity or advanced age (p＜0.05). Persistent AF was noted in 2.3% participants, and the prevalence also increased with age. The logistic regression analysis showed that age (OR=1.054, 95%CI: 1.027-1.018, p＜0.001) , history of drinking (OR=1.752, 95%CI: 1.070-2.867, p＜0.05), chronic heart disease (OR=1.778, 95%CI: 1.156-2.736, p＜0.01), diabetes mellitus (OR=1.792, 95%CI: 1.183-2.713, p＜0.01), and cardiac dysfunction (OR=2.373, 95%CI=1.298-4.337, p＜0.01) were relevant to AF among participants with OSA.Conclusion: The prevalence of AF is significantly common in elderly patients with OSA. Age, history of drinking, chronic heart disease, diabetes mellitus, and cardiac dysfunction are independently related to AF in these patients.