RT Journal
A1 Arias MA, Sánchez AM, Alonso-Fernández A, García-Río F
T1 ATrial fibrillation, obesity, and obstructive sleep apnea
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2007
FD July 23
VO 167
IS 14
SP 1552
OP 1553
DO 10.1001/archinte.167.14.1552-c
UL http://dx.doi.org/10.1001/archinte.167.14.1552-c
AB 
Our comments are focused on the likely role of obstructive sleep apnea (OSA) as one other possible factor contributing to the described association between obesity and new-onset AF, an aspect not evaluated in this study. Obstructive sleep apnea affects 17% to 24% of North Americans adults,2 and patients with AF have a high prevalence of OSA.3 This medical condition is characterized by periodic reduction or cessation of breathing due to narrowing of the upper airways during sleep. Obstructive sleep apnea induces intermittent hypoxia, hypercapnia, sympathetic activation, and abrupt surges in arterial pressure, and it is conceivable that these factors would predispose to the development of AF. Among patients with OSA who underwent electrical cardioversion for AF, in those correctly treated with continuous positive airway pressure (the preferred treatment for OSA), a reduction in the recurrence rate for AF throughout the 1-year follow-up was reported by nearly 50%, compared with those with untreated OSA.4