• Adrian Baranchuk, Helen Pang, Geoffrey E J Seaborn, Payam Yazdan-Ashoori, Damian P Redfearn, Christopher S Simpson, Kevin A Michael, and Michael Fitzpatrick.
• Cardiology Division, Kingston General Hospital, Queen's University, Kingston, ON, Canada. barancha@kgh.kari.net
• J Interv Card Electrophysiol. 2013 Apr 1;36(3):247-53.

BackgroundObstructive sleep apnoea (OSA) is associated with cardiovascular morbidity and mortality, including atrial arrhythmias. Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA; its impact on atrial electrical remodelling has not been fully investigated. Signal-averaged p-wave (SAPW) duration is an accepted marker for atrial electrical remodelling.ObjectiveThe objective of this study is to determine whether CPAP induces reverse atrial electrical remodelling in patients with severe OSA.MethodsConsecutive patients attending the Sleep Disorder Clinic at Kingston General Hospital underwent full polysomnography. OSA-negative controls and severe OSA were defined as apnoea-hypopnea index (AHI) < 5 events/hour and AHI ≥ 30 events/hour, respectively. SAPW duration was determined at baseline and after 4-6 weeks of CPAP in severe OSA patients or without intervention controls.ResultsNineteen severe OSA patients and 10 controls were included in the analysis. Mean AHI and minimum oxygen saturation were 41.4 ± 10.1 events/hour and 80.5 ± 6.5 % in severe OSA patients and 2.8 ± 1.2 events/hour and 91.4 ± 2.1 % in controls. At baseline, severe OSA patients had a greater SAPW duration than controls (131.9 ± 10.4 vs 122.8 ± 10.5 ms; p = 0.02). After CPAP, there was a significant reduction of SAPW duration in severe OSA patients (131.9 ± 10.4 to 126.2 ± 8.8 ms; p < 0.001), while SAPW duration did not change after 4-6 weeks in controls.ConclusionCPAP induced reverse atrial electrical remodelling in patients with severe OSA as represented by a significant reduction in SAPW duration.

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