Start CPAP Therapy in Obstructive Sleep Apnea Patients After Atrial Fibrillation Ablation

Prior treatment

• History of myocardial infarction, percutaneous coronary intervention, or cardiac surgery within 3 months prior to screening.
• History of stroke or transient ischemic attack within 6 months prior to screening.
• Perioperative complications related to the ablation procedure occurring prior to randomization.
• Inability to discontinue antiarrhythmic drugs (AADs) post-procedure due to other reasons.
• Treatment-emergent central sleep apnea during CPAP tolerance assessment that cannot be corrected prior to randomization.
• Receipt of instrumental or surgical treatment for OSA within 3 months prior to screening, including CPAP, oral appliances, ENT surgery, or bariatric surgery.
• Current participation in other drug or device trials.

Other illness

• Comorbid moderate-to-severe mitral stenosis or history of prosthetic valve replacement (mechanical or bioprosthetic).
• Conditions requiring ventilatory support, including obesity hypoventilation syndrome (defined as BMI \> 30kg/m² and awake PaCO₂ \> 45mmHg), amyotrophic lateral sclerosis, or chronic obstructive pulmonary disease with \> 1 episode of respiratory failure or hypercapnia.

Lab values

• Left ventricular ejection fraction \< 30%.
• Use of glucagon-like peptide-1 receptor agonists, glucose-dependent insulinotropic peptide receptor agonists, or glucagon receptor agonists for weight loss within 3 months prior to screening, or plans to initiate such medications within the next year.

Other

• Patients meeting any of the following criteria will be excluded from the study:
• Secondary AF.
• Left atrial anteroposterior diameter 60mm (measured via parasternal long-axis view).
• Pregnant or breastfeeding women.
• Life expectancy \< 1 year.
• Central sleep apnea.

• Patients must meet all of the following conditions to be eligible for the study:
• Age 18-75 years.
• Patients with persistent AF who received catheter ablation for the first time.
• Diagnosed with OSA.
• Able to tolerate CPAP therapy.
• Capable of understanding and complying with the study protocol.
• Willing to sign the informed consent form.