ArticleJournal of the American Heart Association2013
Effect of sleep apnea and continuous positive airway pressure on cardiac structure and recurrence of atrial fibrillation.
Article in Journal of the American Heart Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06618417 (National Decentral/Virtual Randomized Trial Testing Remote Sleep Apnea Evaluation in Patients With Atrial Fibrillation), which is not on this map. Cited by 86 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
National Decentral/Virtual Randomized Trial Testing Remote Sleep Apnea Evaluation in Patients With Atrial Fibrillation
Who cites it
86 citing papers in PubMed, 9 syntheses or guidelines pooled it, 155 citations in OpenAlex.
- Efficacy of continuous positive airway pressure on atrial fibrillation recurrence after catheter ablation in patients with obstructive sleep apnea: a systematic review and meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Pooled it
- The impact of continuous positive airway pressure therapy on the recurrence of atrial fibrillation in patients with obstructive sleep apnea after pulmonary vein isolation.BMC cardiovascular disorders · 2025Pooled it
- Continuous positive airway pressure therapy might be an effective strategy on reduction of atrial fibrillation recurrence after ablation in patients with obstructive sleep apnea: insights from the pooled studies.Frontiers in neurology · 2023Pooled it
- CPAP is associated with decreased risk of AF recurrence in patients with OSA, especially those younger and slimmer: a meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2020Pooled it
- 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2018Guideline
- 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2018Guideline
- European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS).Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2017Guideline
- European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS).European journal of preventive cardiology · 2017Guideline
- Guideline
- Cardiac remodelling in patients with atrial fibrillation and obstructive sleep apnoea.Open heart · 2024Trial
- The Effect of Continuous Positive Airway Pressure on Vascular Function and Cardiac Structure in Diabetes and Sleep Apnea. A Randomized Controlled Trial.Annals of the American Thoracic Society · 2020Trial
- Racial and ethnic disparities in the management of risk factors in individuals with atrial fibrillation: A narrative review.American journal of preventive cardiology · 2026Review
- Atrial fibrillation and metabolic syndrome: an updated review of mechanisms, risk factors, and therapeutic strategies.Frontiers in cardiovascular medicine · 2026Review
- When the Heart Meets the Pillow: Building Cross-disciplinary Solutions for Sleep-disordered Breathing.Cardiac failure review · 2026Review
- The role of cardiac magnetic resonance imaging in obstructive sleep apnea: a systematic scoping review.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Impact of Obstructive Sleep Apnea in Surgical Patients: A Systematic Review.Journal of clinical medicine · 2025Review
- Why Is Sleep Apnea Treatment Success Driven by Patient Choice, Not Randomization?Journal of the American Heart Association · 2025Article
- Multidiagnostic chest-worn patch to detect obstructive sleep apnea and cardiac arrhythmias.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- A comparative study on the hemodynamic effects of initiating positive airway pressure treatment in patients with obstructive and central sleep apnea.Sleep & breathing = Schlaf & Atmung · 2025Article
- Integrated Management of Persistent Atrial Fibrillation.Biomedicines · 2025Review
26 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundSleep apnea (SA) is associated with an increased risk of atrial fibrillation (AF). We sought to determine the effect of SA on cardiac structure in patients with AF, whether therapy for SA was associated with beneficial cardiac structural remodelling, and whether beneficial cardiac structural remodelling translated into a reduced risk of recurrence of AF after pulmonary venous isolation (PVI). METHODS AND
resultsA consecutive group of 720 patients underwent a cardiac magnetic resonance study before PVI. Patients with SA (n=142, 20%) were more likely to be male, diabetic, and hypertensive and have an increased pulmonary artery pressure, right ventricular volume, atrial dimensions, and left ventricular mass. Treated SA was defined as duration of continuous positive airway pressure therapy of >4 hours per night. Treated SA patients (n=71, 50%) were more likely to have paroxysmal AF, a lower blood pressure, lower ventricular mass, and smaller left atrium. During a follow-up of 42 months, AF recurred in 245 patients. The cumulative incidence of AF recurrence was 51% in patients with SA, 30% in patients without SA, 68% in patients with untreated SA, and 35% in patients with treated SA. In a multivariable model, the presence of SA (hazard ratio 2.79, CI 1.97 to 3.94, P<0.0001) and untreated SA (hazard ratio 1.61, CI 1.35 to 1.92, P<0.0001) were highly associated with AF recurrence.
conclusionsPatients with SA have an increased blood pressure, pulmonary artery pressure, right ventricular volume, left atrial size, and left ventricular mass. Therapy with continuous positive airway pressure is associated with lower blood pressure, atrial size, and ventricular mass, and a lower risk of AF recurrence after PVI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.