Shahed Mohd Lame Atassi2, Bassam Atallah1, Terrence J. Lee-St. John1, Wael Almahmeed1, Khalid Almuti1

1Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates, 2Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates

Background:
Obstructive sleep apnea (OSA) is a serious sleep disorder that has been strongly linked to atrial fibrillation (AF). Specialized AF clinics identify the presence of AF-modifying co-morbidities to allow proper diagnosis and management. Very few specialized AF clinics exist in the Middle East Gulf (MEG) region.

Purpose:
We sought to explore the characteristics of patients referred to a unique multidisciplinary AF clinic in the MEG region and the prevalence of OSA including factors influencing sleep study referrals.

Method(s):
A retrospective chart review of the first 100 patients referred to a specialized AF clinic in the MEG region between 2017 and 2019 was conducted. Data collected included demographics, comorbidities and medications. We also documented sleep study referrals and formal diagnosis of OSA (those with Apnea-Hypopnea Index of ≥5).

Result(s):
Of the 100 patients included, 54% were male and mean age was 59 years. The mean CHA2DS2-VASc Score was 2.6 ± 1.9 and mean BMI was 32.3 ± 7.4. Most patients (74%) were on anticoagulation with apixaban being the most common agent (28%). (Table 1). Only 5% had a sleep study done prior to the visit.  54 patients were referred for a sleep study; 32 patients actually completed it, of which 31 (97%) were diagnosed with OSA. The only significant predictor for referral to sleep study in our model was BMI (odds of referral increased by 26% for each 1 kg/m2 increase in BMI).

Conclusion(s):
OSA is very common in AF patients in MEG and is correlated with higher BMI. Establishment of a specialized AF clinic in the MEG region correctly identifies patients at high risk of OSA.