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Nat Clin Pract Cardiovasc Med. 2004 Nov;1(1):56-9, quiz 1 p following 59.

Atrial fibrillation, sleep apnea and obesity.

Author information

1
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk F-15, Cleveland, OH 44195, USA. chungm@ccf.org

Abstract

BACKGROUND:

A 60-year-old male with obesity (body-mass index 43 kg/m(2)) presented with recurrent symptomatic atrial fibrillation (AF), which he had had since age 41 years. The AF was refractory to treatment with antiarrhythmic drugs. Pacemaker implantation for tachycardia-bradycardia syndrome was required as well as ablation for atrial flutter, and the patient underwent a total of four DC cardioversions. Sleep studies showed mild to moderate obstructive sleep apnea, but continuous positive airway pressure was not tolerated. Pacemaker interrogations demonstrated mode-switch episodes, indicating continuing AF. He was scheduled for catheter ablation targeting pulmonary vein antral isolation. He embarked on a weight-loss program, which successfully reduced AF burden.

INVESTIGATIONS:

Echocardiography, stress testing, polysomnography, pacemaker interrogations and C-reactive protein.

DIAGNOSIS:

AF, atrial flutter, tachycardia-bradycardia syndrome, obstructive sleep apnea and morbid obesity.

MANAGEMENT:

Antiarrhythmic drug therapy, DC cardioversion, anticoagulation, atrial flutter ablation, permanent pacemaker implantation, continuous positive airway pressure and weight loss.

PMID:
16265261
DOI:
10.1038/ncpcardio0027
[Indexed for MEDLINE]
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