Clinical Study on the Effect of CPAP on AF Recurrence After Catheter Ablation in Patients with AF and OSA

Recruiting now

Conditions studied: Atrial Fibrillation, Continuous Positive Airway Pressure, Obstructive Sleep Apnea, Recurrence, Observational Study

In brief

Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice, significantly increasing the risks of death, stroke, heart failure, cognitive impairment, and dementia, thus severely impacting patients' quality of life. However, for AF patients with concomitant cardiovascular risk factors, particularly those with obstructive sleep apnea (OSA), the success rate of catheter ablation is significantly reduced. Continuous positive airway pressure (CPAP) is currently an effective treatment for OSA, effectively correcting nocturnal intermittent hypoxia and fragmented sleep caused by OSA. However, the effect of CPAP therapy on AF recurrence in patients with OSA undergoing catheter ablation remains controversial. Faced with conflicting research findings, our team recently conducted a meta-analysis (registration number CRD42023398588) to assess the impact of CPAP on AF recurrence post catheter ablation in patients with AF and OSA, suggesting that CPAP significantly reduces AF recurrence post catheter ablation (RR = 0.58, P \< 0.01). However, considering the limited number of included studies, potential bias risks, and confounding factors, our meta-analysis results await further confirmation through real-world studies by our team. Therefore, our team plans to conduct further research on the impact of CPAP on AF recurrence post catheter ablation in patients with moderate to severe OSA, aiming to provide clinical guidance for the treatment of AF in patients with moderate to severe OSA.

Key facts

Study ID: NCT06542263
Run by: Second Affiliated Hospital of Soochow University
People needed: 224
Starts: 2024-08-09
Expected to finish: 2026-08-01
Last updated by the study team: 2025-01-23

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Clinical diagnosis of AF combined with moderate to severe OSA (OSA diagnostic criteria: apnea hypopnea index (AHI) greater than 15/hour, and at least 80% of all events are respiratory sleep obstructive events; AF includes persistent atrial fibrillation and paroxysmal atrial fibrillation)
Age ≥ 18 years old
The patient voluntarily participates in the project and signs informed consent
All patients undergo overnight sleep pressure titration at the sleep center to determine the minimum pressure value for continuous positive airway pressure ventilation at home. All patients are required to undergo CPAP treatment at home at least 5 days a week, with each session lasting at least 4 hours

You may not qualify if…

Patients with neuromuscular disorders, pulmonary hypopnea, and severe lung diseases
Preoperative confirmation of thrombus in the left atrium
The patient has no desire for conversion
Secondary atrial fibrillation (hyperthyroidism, tumors, etc.)
Individuals with contraindications to anticoagulants
Left atrial diameter (LAD) exceeding 60mm (2D echocardiography long axis section data)
Pregnant women
History of myocardial infarction, percutaneous coronary intervention, and cardiac surgery in the past three months
Stroke or transient ischemic attack in the past six months
After artificial valve implantation surgery
Severe renal insufficiency (creatinine Cr>2.5mg/dl or>221umol/L, or glomerular filtration rate eGFR<30ml/min/1.73m2)
Acute diseases or active infections that occur before surgery, recorded as pain, fever, positive blood culture, and/or leukocytosis, or have been treated with antibiotics.
Expected survival period<1 year

Where it is running

The Second Affiliated Hospital of Soochow University — Suzhou, Jinagsu, China (enrolling)

Full record on ClinicalTrials.gov

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