Incidence and Risk of Atrial Fibrillation in Sleep-Disordered Breathing Without Coexistent Systemic Disease – Nationwide Longitudinal Cohort Study –

Tze-Fan Chao; Chia-Jen Liu; Su-Jung Chen; Kang-Ling Wang; Yenn-Jiang Lin; Shih-Lin Chang; Li-Wei Lo; Yu-Feng Hu; Ta-Chuan Tuan; Tzeng-Ji Chen; Chuen-Wang Chiou; Shih-Ann Chen

doi:10.1253/circj.CJ-14-0222

Arrhythmia/Electrophysiology

Incidence and Risk of Atrial Fibrillation in Sleep-Disordered Breathing Without Coexistent Systemic Disease

– Nationwide Longitudinal Cohort Study –

Tze-Fan Chao, Chia-Jen Liu, Su-Jung Chen, Kang-Ling Wang, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tzeng-Ji Chen, Chuen-Wang Chiou, Shih-Ann Chen

Author information

Tze-Fan Chao
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University
Division of Cardiology, Taipei Municipal Gan-Dau Hospital
Chia-Jen Liu
Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital
Su-Jung Chen
Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital
Kang-Ling Wang
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University
Yenn-Jiang Lin
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University
Shih-Lin Chang
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University
Li-Wei Lo
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University
Yu-Feng Hu
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University
Ta-Chuan Tuan
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University
Division of Cardiology, Taipei Municipal Gan-Dau Hospital
Tzeng-Ji Chen
Department of Family Medicine, Taipei Veterans General Hospital
Chuen-Wang Chiou
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University
Division of Cardiology, Kaohsiung Veterans General Hospital
Shih-Ann Chen
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University

Keywords: Atrial fibrillation, Incidence, Sleep-disordered breathing

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Supplementary material

2014 Volume 78 Issue 9 Pages 2182-2187

DOI https://doi.org/10.1253/circj.CJ-14-0222

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Abstract

Background:Although the link between sleep-disordered breathing (SDB) and atrial fibrillation (AF) has been reported, a population-based longitudinal cohort study was lacking. The goal of the present study was to investigate the AF risk carried by SDB, using the National Health Insurance Research Database in Taiwan.Methods and Results:From 2000 to 2001, a total of 579,521 patients who had no history of cardiac arrhythmias or significant comorbidities were identified. Among them, 4,082 subjects with the diagnosis of SDB were selected as the study group, and the remaining 575,439 subjects constituted the control group. The study endpoint was the occurrence of new-onset AF. During a follow-up of 9.2±2.0 years, there were 4,023 patients (0.7%) experiencing new-onset AF. The occurrence rate of AF was higher in patients with SDB compared to those without it (1.3% vs. 0.7%, P<0.001). The AF incidences were 1.38 and 0.76 per 1,000 person-years for patients with and without SDB, respectively. After anadjustment for age and sex, SDB was a significant risk factor of AF with a hazard ratio of 1.536. The AF risk increased with increasing clinical severity of SDB, represented by the requirement of continuous positive airway pressure use.Conclusions:SDB itself, without the coexistence of other systemic diseases, was a risk factor of AF. (Circ J2014;78:2182–2187)

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