Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists
Background: Among international cardiologists it is unclear whether equipoise exists regarding the benefit of diagnosing and managing obstructive sleep apnea (OSA) to improve atrial fibrillation (AF) outcomes and whether clinical practice and equipoise are linked. Methods: Between January 2019 and J...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906722001348 |
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| author | Michael D. Faulx Reena Mehra Glaucylara Reis Geovanini Shin-ichi Ando Michael Arzt Luciano Drager Michael Fu Camilla Hoyos Jo Hai Juey-Jen Hwang Remzi Karaoguz John Kimoff Pei-Lin Lee Olga Mediano Sanjay R. Patel Yüksel Peker Jean Louis Pepin Manuel Sanchez-de-la-Torre Frédéric Sériès Stefan Stadler Patrick Strollo A.A. Tahrani Erik Thunström Motoo Yamauchi Susan Redline Craig L. Phillips |
| author_facet | Michael D. Faulx Reena Mehra Glaucylara Reis Geovanini Shin-ichi Ando Michael Arzt Luciano Drager Michael Fu Camilla Hoyos Jo Hai Juey-Jen Hwang Remzi Karaoguz John Kimoff Pei-Lin Lee Olga Mediano Sanjay R. Patel Yüksel Peker Jean Louis Pepin Manuel Sanchez-de-la-Torre Frédéric Sériès Stefan Stadler Patrick Strollo A.A. Tahrani Erik Thunström Motoo Yamauchi Susan Redline Craig L. Phillips |
| author_sort | Michael D. Faulx |
| collection | DOAJ |
| description | Background: Among international cardiologists it is unclear whether equipoise exists regarding the benefit of diagnosing and managing obstructive sleep apnea (OSA) to improve atrial fibrillation (AF) outcomes and whether clinical practice and equipoise are linked. Methods: Between January 2019 and June 2020 we distributed a web-based 12-question survey regarding OSA and AF management to practicing cardiologists in 16 countries. Results: The United States, Japan, Sweden, and Turkey accounted for two-thirds of responses. 863 cardiologists responded; half were general cardiologists, a quarter electrophysiologists. Responses regarding treating OSA with CPAP to improve AF endpoints were mixed. 33% of respondents referred AF patients for OSA screening. OSA was diagnosed in 48% of referred patients and continuous positive airway pressure (CPAP) was prescribed for 59% of them. Nearly 70% of respondents believed randomized controlled trials (RCTs) of OSA treatment in AF patients were necessary and indicated willingness to contribute to such trials. Conclusions: There was no clinical equipoise among surveyed cardiologists; a majority expressed certainty that combined OSA and AF treatment is superior to AF treatment alone for improving AF outcomes. However, a minority of surveyed cardiologists referred AF patients for OSA testing, and while half of screened AF patients had OSA, CPAP was prescribed in little more than half of them, reflecting the view that better clinical trial evidence is needed to support this practice. Our results underscore the need for larger, multi-national prospective studies of OSA treatment and AF outcomes to inform more uniform society guideline recommendations. |
| first_indexed | 2024-04-13T20:40:28Z |
| format | Article |
| id | doaj.art-2b2d714499ab492fab8b241f497aa44a |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-13T20:40:28Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-2b2d714499ab492fab8b241f497aa44a2022-12-22T02:30:52ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672022-10-0142101085Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologistsMichael D. Faulx0Reena Mehra1Glaucylara Reis Geovanini2Shin-ichi Ando3Michael Arzt4Luciano Drager5Michael Fu6Camilla Hoyos7Jo Hai8Juey-Jen Hwang9Remzi Karaoguz10John Kimoff11Pei-Lin Lee12Olga Mediano13Sanjay R. Patel14Yüksel Peker15Jean Louis Pepin16Manuel Sanchez-de-la-Torre17Frédéric Sériès18Stefan Stadler19Patrick Strollo20A.A. Tahrani21Erik Thunström22Motoo Yamauchi23Susan Redline24Craig L. Phillips25Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA; Corresponding author.Director, Sleep Disorders Research. Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USASleep Laboratory, Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilSleep Apnea Center. Kyushu University Hospital, 3-1-1 Maidashi Higashiku Fukuoka, 814-8582, JapanDepartment of Internal Medicine II, University Hospital Regensburg, Franz-Josef-Strauss-Allee (u1) 11, 93053 Regensburg, GermanyUnidade de Hipertensao, Institute do Coraçao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BrazilSenior Consultant Physician/Cardiologist, University of Gothenburg, Su sahlgrenska, 41345 Göteborg, SwedenThe University of Sydney, Faculty of Science, School of Psychology, Sydney, Australia and Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Glebe, Sydney, AustraliaQueen Mary Hospital and LKS Faculty of Medicine, the University of Hong Kong, Hong KongCardiovascular Division, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, No. 7, Chung Shan S. Rd, Taipei 100225, TaiwanDepartment of Cardiology, Güven Hospital, Cankaya, 06540 Ankara, TurkeyRespiratory Division, Room D05.2505. McGill University Health Centre, Glen Site 1001 Décarie, Montréal, Québec H4A 3J1, CanadaCenter of Sleep Disorders, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Taipei 100225, TaiwanSleep Unit, Pneumology Department, Hospital Universitario de Guadalajara. Medicine Department. Universidad de Alcalá. Madrid. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, SpainCenter for Sleep and Cardiovascular Outcomes Research, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USADepartment of Pulmonary Medicine, Koc University School of Medicine, Istanbul, TurkeyHP2 Laboratory, Grenoble Alpes University/INSERM U 1300 Unit, Faculty of Medicine, Domaine de la Merci, 38700 La Tronche, FrancePrecision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy. University of Lleida, Lleida, Spain. 2 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, CIBERES, Madrid, SpainDépartement de Médecine Université Laval. Centre de Pneumologie, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 chemin sainte Foy, Québec, Québec G1V 4G5, CanadaDepartment of Internal Medicine II, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, GermanyDivision of Allergy, Pulmonary and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USAInstitute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, UK. Centre for endocrinology, diabetes and metabolism (CEDAM), Birmingham Health Partners, Birmingham, UKDepartment of Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, SwedenDepartment of Respiratory Medicine. Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanBrigham and Women's Hospital. Department of Medicine, Division of Sleep and Circadian Disorders. 75 Francis Street, Boston, MA 02115, USAMacquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, AustraliaBackground: Among international cardiologists it is unclear whether equipoise exists regarding the benefit of diagnosing and managing obstructive sleep apnea (OSA) to improve atrial fibrillation (AF) outcomes and whether clinical practice and equipoise are linked. Methods: Between January 2019 and June 2020 we distributed a web-based 12-question survey regarding OSA and AF management to practicing cardiologists in 16 countries. Results: The United States, Japan, Sweden, and Turkey accounted for two-thirds of responses. 863 cardiologists responded; half were general cardiologists, a quarter electrophysiologists. Responses regarding treating OSA with CPAP to improve AF endpoints were mixed. 33% of respondents referred AF patients for OSA screening. OSA was diagnosed in 48% of referred patients and continuous positive airway pressure (CPAP) was prescribed for 59% of them. Nearly 70% of respondents believed randomized controlled trials (RCTs) of OSA treatment in AF patients were necessary and indicated willingness to contribute to such trials. Conclusions: There was no clinical equipoise among surveyed cardiologists; a majority expressed certainty that combined OSA and AF treatment is superior to AF treatment alone for improving AF outcomes. However, a minority of surveyed cardiologists referred AF patients for OSA testing, and while half of screened AF patients had OSA, CPAP was prescribed in little more than half of them, reflecting the view that better clinical trial evidence is needed to support this practice. Our results underscore the need for larger, multi-national prospective studies of OSA treatment and AF outcomes to inform more uniform society guideline recommendations.http://www.sciencedirect.com/science/article/pii/S2352906722001348Sleep apneaAtrial fibrillationSurveyInternationalClinical equipoise |
| spellingShingle | Michael D. Faulx Reena Mehra Glaucylara Reis Geovanini Shin-ichi Ando Michael Arzt Luciano Drager Michael Fu Camilla Hoyos Jo Hai Juey-Jen Hwang Remzi Karaoguz John Kimoff Pei-Lin Lee Olga Mediano Sanjay R. Patel Yüksel Peker Jean Louis Pepin Manuel Sanchez-de-la-Torre Frédéric Sériès Stefan Stadler Patrick Strollo A.A. Tahrani Erik Thunström Motoo Yamauchi Susan Redline Craig L. Phillips Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists International Journal of Cardiology: Heart & Vasculature Sleep apnea Atrial fibrillation Survey International Clinical equipoise |
| title | Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists |
| title_full | Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists |
| title_fullStr | Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists |
| title_full_unstemmed | Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists |
| title_short | Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists |
| title_sort | obstructive sleep apnea and its management in patients with atrial fibrillation an international collaboration of sleep apnea cardiovascular trialists incosact global survey of practicing cardiologists |
| topic | Sleep apnea Atrial fibrillation Survey International Clinical equipoise |
| url | http://www.sciencedirect.com/science/article/pii/S2352906722001348 |
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