A recent study has found that there is mutual relationship between central sleep apnea (CSA) and atrial fibrillation (AF). Central sleep apnea is a breathing related sleep disorder where a person pauses to breathe or takes shallow breaths for short intervals in his sleep. However, in AF the patients encounter an irregular and rapid heart rhythm. This happens due to abnormal electrical impulses in the heart. This irregularity can be both continuous and intermittent. Let us see why patients with CSA have a high prevalence of AF or vice versa.
What is the Link Between CSA and AF?
The relationship between AF and CSA can be explained in three different ways: AF predisposes the patient towards CSA, patients with CSA have a high possibility of contracting AF and lastly any abnormality in central cardiorespiratory regulation can cause both CSA and AF. AF reduces the pumping efficiency of the heart. This reduces the cardiac outcome and increases the pulmonary vascular pressures are raised. The rise in the pressure can stimulate the pulmonary vagal irritant receptor that can result in hyperventilation and hypocapnia. Similarly CSA can cause AF too. CSA causes disruption in breathing. The patients tend to hyperventilate to bring the respiratory control system under stability. This causes hypocapnia that tampers with the transmembrane currents. The cardiac electrical stability is lost. Patients with central apnea and atrial fibrillation are administered with overdrive atrial pacing to normalize breathing pace.
What is Overdrive Atrial Pacing?
In this a dynamic atrial overdrive algorithm is used in combination with a dual-chamber pacing device. The device produces a rate to pace above the patient’s inherent rate. It increases the pacing when the there is a disruption. As a result the patients do not tend to hyperventilate. This ameliorates the symptoms successfully.
Final Words on Central Sleep Apnea and Arterial Fibrillation
I hope this article on CSA and AF was useful in highlighting AF as a trigger for central sleep apnea and wish you luck in finding riddance over respiratory sleep problems.
