Impacts of atrial fibrillation on sleep-disordered breathing: Insights from two heart failure cases

Abstract

Respiratory stability time (RST) has been proposed as an index for assessing heart failure-related sleep-disordered breathing. This case report examines the impact of catheter ablation for atrial fibrillation (AF) on RST and its relationship with heart failure. Two patients were analyzed: one with preserved ejection fraction (Case 1) and one with reduced ejection fraction (Case 2). In Case 1, RST improved significantly following ablation, accompanied by a decrease in plasma B-type natriuretic peptide levels. In contrast, while B-type natriuretic peptide levels decreased post-ablation in Case 2, RST showed minimal change, suggesting that the hemodynamic effects of restoring sinus rhythm had a lesser impact on respiratory stability. These findings indicate that the contribution of AF to the worsening of sleep-disordered breathing in heart failure differs between preserved and reduced ejection fraction. Further investigation of the association between RST and AF may offer valuable insights into the complex relationship between AF and heart failure.

Learning objective

This case report is the first to demonstrate changes in nocturnal respiratory dysfunction after catheter ablation for atrial fibrillation in heart failure. Quantitative assessment of respiratory stability may help elucidate the role of atrial fibrillation in heart failure.