Kardiologia polska 2017 02 09() doi 10.5603/KP.a2017.0023
Atrial fibrillation (AF) constitutes the most prevalent arrhythmia affecting up-to 2% percent of general population. Apart from well-established risk factors which increase the odds for the development of AF e.g. age or arterial hypertension, recent analyses indicated that obstructive sleep apnea (OSA) may independently, negatively modify arrhythmia occurrence profile. Concurrently, erectile dysfunction (ED) is commonly neglected, potent marker of cardiovascular risk which considerably worsens men’s psychological state. Unrecognized, and untreated ED results in substantial deterioration of patient’s therapeutic program adherence. Owing to the fact that AF, OSA and ED share multiple risk factors and clinical consequences, in 2013 concept of their frequent concurrence – the OSAFED syndrome was proposed .
The aim of the study was to evaluate the prevalence of OSAFED patients with atrial fibrillation in primary care practice.
Retrospective analysis of data from primary care physician charts, NZOZ Esculap Gniewkowo, central Poland, including 1372 men aged 40-65. The primary goal was to determine the diagnosis of paroxysmal and/or permanent atrial fibrillation, which was followed by sleep apnea screening (polygraphy) and erectile function evaluation (IIED-5 questionnaire).
21 patients (1.5%) with documented AF were identified. Based on the sleep-polygraphic studies 14 (67%) of them had the confirmation of OSA with mean apnea-hypopnea index equal to 27.5±17.1 (mean ±SD). Furthermore, eleven patients (52%) met OSAFED syndrome criteria. Patients with OSAFED syndrome had the mean score in IIEF-5 of 11.6 ±3.5. The OSAFED-patients who were not diagnosed with all the of the syndrome components prior to the study-enrollment were characterized by substantially lower fat excess comparing to their counterparts with already established OSAFED (BMI=30.1 ±4.9 vs. 37.7 ±3.9 kg/m²; respectively; P=0.03).
Frequently coexisting OSAFED syndrome components in all AF patients from primary care setting should encourage more active search of OSA and ED in patients with documented any form of atrial fibrillation. Most of the studied patients did not have the diagnosis of OSA nor ED done prior to the participation in the study.