Project Title

Atrial Mechano-Electrical Coupling in Obstructive Sleep Apnea

Background

AF very often co-exists with OSA. AF etiology is complex, but involves a mechano-electrical coupling in which a mechanical stimulus alters the atrial electrophysiology. Because OSA induces an imbalance in the autonomous nervous system, hypoxia, and altered hemodynamics, these pathological factors are considered to cause OSA-induced AF, with the mechanical stress expected to be the major triggering factor. However, direct evidence of OSA-induced atrial stretch causing AF is lacking.

Aim

This project investigates atrial mechano-electrical coupling during OSA in established large animal models and humans.

Methods

We will perform extensive state-of-the-art catheter-based electrophysiological studies and dynamic cardiac imaging by computer tomography and magnetic resonance imaging during short obstructive respiratory events in both an in-vivo porcine model of OSA (negative intrathoracic pressure of ~50 mbar) and in patients with atrioventricular nodal reentry tachycardia (performing Müller maneuvers).

Additional information

This translational project will improve our mechanistic understanding of how OSA causes AF. It will serve as basis for improving patient stratification and the development of personalized therapies for AF and OSA, such as stretch-reducing atrial ablation lesions by catheter ablation.