Origin of Premature Atrial Beats Induced by Simulated Obstructive Sleep Apnea

University of Zurich (UZH)

Status: Terminated

Conditions: Atrial Fibrillation; Sleep Apnea, Obstructive; Atrial Premature Complexes

Treatments: Procedure: Standard pulmonary vein isolation

Study type: Interventional

Funder types: Other

Identifiers

NCT02269774

KEK-ZH-Nr. 2014-0203

Details and patient eligibility

About

There is accumulating evidence for obstructive sleep apnea (OSA) as an independent risk factor for paroxysmal atrial fibrillation and for high recurrence rates of atrial fibrillation after ablation therapy. We have previously shown that simulated OSA triggers premature atrial beats (PABs) by acute changes in intra-thoracic pressure. Most episodes of atrial fibrillation are initiated by PABs. However, the origin of PABs induced by intra-thoracic pressure swings is unknown. This study investigates the origin of premature atrial beats induced by intra-thoracic pressure changes that simulate obstructive sleep apnea in patients with atrial fibrillation.

Enrollment: 2 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• History of ECG-documented paroxysmal atrial fibrillation within the last 12 months and currently in sinus rhythm
• Scheduled for circumferential pulmonary venous isolation treatment
• 18 to 75 years of age
• Signed informed consent

Exclusion criteria

• Treated with class III anti-arrhythmic agents (at the moment of pulmonary venous isolation)
• Treated for obstructive sleep apnea
• Previous catheter ablation in the pulmonary veins or left atrium
• Severe structural heart disease
• Mental or physical disability precluding informed consent or compliance with the protocol
• Enrolled in another study that would confound the results of this trial

Trial design

Primary purpose: Basic Science

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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2 participants in 2 patient groups

Pulmonary vein isolation

Other group

Description:

Intra-thoracic pressure swings induced by breathing manoeuvres during standard catheter-ablation procedure. Catheter-based electrical mapping and pressure in the left atrium and pulmonary veins during standard catheter-ablation procedure. Only patients with an apnea-hypopnea index \> 5/h and documented premature atrial beats during the Mueller manoeuvre will be eligible for the catheter-based electrical mapping. Follow-up after 1 year for atrial fibrillation recurrence.

Treatment:

Procedure: Standard pulmonary vein isolation

No intevention

No Intervention group

Description:

Intra-thoracic pressure swings induced by breathing manoeuvres during ECG-monitoring. Only patients with an apnea-hypopnea index \< 5/h and no premature atrial beats during the Mueller manoeuvre will be assigned to the no intervention arm.