Does Surgical Treatment With Uvulopalatopharyngoplasty for Obstructive Sleep Apnea Prevent Future Arrhythmic Events?

Abstract

Introduction: Obstructive sleep apnea (OSA) is a known risk factor for cardiac arrhythmia. The impact of surgical OSA treatment on the future occurrence of arrhythmic disease in young patients remains insufficiently studied.

Purpose: This study aimed to determine if surgical OSA treatment reduces future arrhythmic events (atrial fibrillation [AF], premature beats, ventricular arrhythmias, and sudden cardiac arrest [SCA]) and if these effects persist over time.

Methods: This study was a retrospective cohort data analysis of the dataset from the Korean National Health Insurance Service system (2009-2020) on 359,851 OSA patients. Propensity score matching (PSM) compared surgical treatment with uvulopalatopharyngoplasty (UPPP) and a control group, resulting in a cohort of 117,665 participants (85.4% men, average age 45.5 ±14.0). Over 5 years, occurrences of AF, premature beats, ventricular arrhythmias, and SCA were evaluated.

Results: The control group showed a linear increase in arrhythmic disease. The surgical treatment group had a lower incidence of arrhythmias. PSM showed significant reductions in AF, premature beats, ventricular arrhythmias, and SCA in the surgical treatment group. AF incidence was 5 times higher in the control group (HR 5.384), premature beats were 4 times higher (HR 4.284), ventricular arrhythmias were 11 times higher (HR 11.758), and SCA was over 24 times higher (HR 24.089).

Conclusion: Young patients with OSA exhibited a progressively increasing trend in arrhythmic events over time. Surgical treatment with UPPP in a similar patient population was associated with a reduction in the incidence of these conditions.