The Interconnection between Obstructive Sleep Apnea and Persistent Atrial Fibrillation: Pathophysiology, Clinical Implications, and Management Strategies

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Donaldo Emiliano Silva López
Jhonattan Daniel Castro Pére
Isidro Fabián Martínez Valeriano
Lorenzo Ricardo Morales Rodríguez
Alma Pamela Huerta Alvarado
Marcela Martínez Celis González

Abstract

Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by intermittent upper airway obstruction, resulting in recurrent hypoxemia, hypercapnia, and sleep fragmentation. Emerging evidence highlights a significant association between OSA and persistent atrial fibrillation (AF), a complex arrhythmia with substantial morbidity and mortality. This relationship is underpinned by multifaceted pathophysiological mechanisms, including autonomic nervous system dysregulation, structural and electrical cardiac remodeling, systemic inflammation, and heightened oxidative stress. Patients with coexistent OSA and AF exhibit a more challenging clinical course with higher rates of arrhythmia recurrence and resistance to conventional therapies such as antiarrhythmic drugs and catheter ablation.


This review explores the intricate interplay between OSA and persistent AF, emphasizing the role of continuous positive airway pressure (CPAP) therapy in modifying arrhythmogenic risk and improving cardiovascular outcomes. Furthermore, the article discusses the importance of multidisciplinary approaches for diagnosis and management, integrating cardiological and sleep medicine perspectives. Understanding this bidirectional relationship is crucial for tailoring therapeutic strategies aimed at mitigating the burden of AF in patients with OSA.

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Donaldo Emiliano Silva López, Jhonattan Daniel Castro Pére, Isidro Fabián Martínez Valeriano, Lorenzo Ricardo Morales Rodríguez, Alma Pamela Huerta Alvarado, & Marcela Martínez Celis González. (2025). The Interconnection between Obstructive Sleep Apnea and Persistent Atrial Fibrillation: Pathophysiology, Clinical Implications, and Management Strategies. International Journal of Medical Science and Clinical Research Studies, 5(1), 100–106. https://doi.org/10.47191/ijmscrs/v5-i01-18
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