The relationship between obstructive sleep apnea and recurrence of atrial fibrillation after pulmonary vein isolation using a contact force–sensing catheter

  • Rintaro Hojo
  • Seiji Fukamizu
  • Satoshi Miyazawa
  • Iwanari Kawamura
  • Harumizu Sakurada
  • Masayasu Hiraoka



Our aim was to elucidate the relationship between obstructive sleep apnea (OSA) and atrial fibrillation (AF) recurrence after repeated pulmonary vein isolation (PVI).


We conducted a non-randomized observational study, with the data prospectively collected. One hundred patients (paroxysmal AF, n = 89) underwent PVI using a contact force–sensing catheter. All patients underwent an electrophysiological study and additional ablation for left atrium-pulmonary vein (PV) reconnection and non-PV foci, 6 months after the first treatment session, regardless of AF recurrence. Those with an apnea-hypopnea index ≥ 15 were diagnosed with OSA. Continuous positive air pressure (CPAP) therapy was initiated after the second treatment session, based on results of a sleep study. For analysis, patients were classified into the non-OSA (n = 66), treated OSA (OSA patients undergoing CPAP; n = 11), and untreated OSA (n = 23) groups, and between-group differences evaluated.


After the first session, AF recurrence was observed in 18.2% (12/66) and 14.7% (5/34) of patients without and with OSA, respectively (P = 0.678). After the second procedure, the rate of AF recurrence was 12.1% (8/66) in the non-OSA group, 9.1% (1/11) in the treated OSA group, and 8.7% (2/23) in the untreated OSA group (log-rank P = 0.944).


The rate of AF recurrence might not be greater in patients with untreated OSA than in those without OSA and those with treated OSA after repeated PVI, using a contact force–sensing catheter, for patients with paroxysmal or short-term persistent AF.


Atrial fibrillation Pulmonary vein isolation Obstructive sleep apnea Continuous positive air pressure Contact force–sensing catheter 


Author contributions

Rintaro Hojo designed the study and wrote the initial draft of the manuscript. Seiji Fukamizu and Masayasu Hiraoka contributed to analysis and interpretation of data. All other authors have contributed to data collection and interpretation and critically reviewed the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of CardiologyTokyo Metropolitan Hiroo HospitalTokyoJapan
  2. 2.Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo HospitalTokyoJapan
  3. 3.Tokyo Medical and Dental UniversityTokyoJapan

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