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

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.