CurrentCardio
Get Weekly

Arrhythmias & electrophysiologyCohort study

Bidirectional temporal association of device-detected atrial fibrillation and sleep apnea

Heart RhythmPublished

  • day-level, time-stratified intraindividual case-crossover analyses
  • prospective ACaSA study
  • continuous remote monitoring
  • generalized linear mixed-effects models as secondary analyses
Read the original article ↗

Authors' conclusion

Continuous monitoring identified a bidirectional temporal association between DDAF and DDSA. Incident severe DDSA was preceded by higher odds of elevated DDAF burden, whereas both incident DDAF episode onset and continuation of ongoing episodes were preceded by higher odds of severe DDSA.

Study context

Population
Pacemaker patients undergoing continuous remote monitoring, September 2020 to August 2025112,242 patient-days analyzed
Participants
218 patients
Exposure
Bidirectional day-to-day association between device-detected AF (DDAF) and device-detected SA (DDSA): preceding-day DDAF burden and incident severe DDSA; preceding-night severe DDSA and DDAF episode onset or continuation

Main finding

As reported in the abstract

Elevated DDAF burden on the previous day preceding incident severe DDSA (pathway 1) · previous day
higher odds preceding incident severe DDSA; all P ≤ .005
Odds ratio (95% CI)P value
DDAF burden 6 minutes to 1 hour
1.38(1.10–1.74)
P ≤ 0.005
DDAF burden 1-12 hours
1.81(1.52–2.15)
P ≤ 0.005
DDAF burden ≥12 hours
2.52(1.97–3.22)
P ≤ 0.005

Observational data: associations, not effects.

Further findings

Severe DDSA on the previous night preceding incident DDAF episode onset (pathway 2)

ComparisonOR (95% CI)P value
severe DDSA on the previous night · higher odds preceding incident DDAF episode onset1.35 (1.10–1.64)P = 0.003

Severe DDSA on the previous night preceding continuation of ongoing DDAF episodes (pathway 3)

ComparisonOR (95% CI)P value
severe DDSA on the previous night · higher odds preceding continuation of ongoing DDAF episodes2.39 (1.47–3.88)P < 0.001

Original publication

Bidirectional temporal association of device-detected atrial fibrillation and sleep apnea. Heart Rhythm. Published 18 July 2026. doi:10.1016/j.hrthm.2026.07.026
Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it