Impact of sleep disordered breathing on postoperative atrial fibrillation in patients who underwent cardiac surgery: a meta-analysis

Objective: An increasing number of studies suggest that sleep disordered breathing (SDB) may be associated with postoperative atrial fibrillation (POAF), but these studies present discrepant results. Thus, this meta-analysis aimed to synthesize the data associating SDB with POAF in patients who underwent cardiac surgery. Methods: A literature search was performed in the Scopus, PubMed, Web of Science, EMBASE, CENTRAL, Weipu, Wanfang Data, and China National Knowledge Infrastructure databases before August 2022. Data were extracted, and the strength of the relationship between SDB and the risk of POAF was evaluated using odds ratio (OR) and 95% confidence intervals (CIs). All statistical analysis was carried out using the Stata 12.0 software. Results: A total of 24 studies with 660,685 subjects were included in current meta-analysis. SDB was significantly associated with the risk of POAF in the patients who underwent cardiac surgery (OR = 1.49; 95% CI, 1.30–1.70; p < .001). Next subgroup analysis revealed that such association may be increased in the group with medical equipment-measured SDB (OR = 2.27; 95% CI, 1.59–3.23; p < .001), prospective studies (OR = 2.17; 95% CI, 1.55–3.03; p < .001), patients without a previous history of atrial fibrillation (OR = 2.04; 95% CI, 1.47–2.82; p < .001), and patients who received a coronary artery bypass graft (OR = 2.10; 95% CI, 1.45–3.05; p < .001). No publication bias was identified. Conclusion: KEY MESSAGES: Patients with SDB who underwent cardiac surgery showed increased risk of POAF. The relationship between SDB and POAF should be explained with caution with the consideration of various covariate. The effect of pre-treatment of SDB on POAF should be examined in future.