BACKGROUND: Atrial fibrillation (AF) constitutes the most prevalent arrhythmia, 
affecting up-to 2% of the general population. Apart from well-established risk 
factors that increase the odds for the development of AF, e.g. age or arterial 
hypertension, recent analyses indicate that obstructive sleep apnoea (OSA) may 
independently, negatively modify the arrhythmia occur-rence profile. 
Concurrently, erectile dysfunction (ED) is a commonly neglected, potent marker 
of cardiovascular risk, which considerably worsens men's psychological state. 
Unrecognised or untreated ED results in substantial deterioration of the 
patient's therapeutic programme adherence. Because AF, OSA, and ED share 
multiple risk factors and clinical consequences, in 2013 the concept of their 
frequent concurrence - OSAFED syndrome - was proposed.
AIM: The aim of the study was to evaluate the prevalence of OSAFED patients with 
AF in primary care practice.
METHODS: Retrospective analysis was carried out of data from primary care 
physician charts (NZOZ Esculap Gniewkowo, central Poland) including 1372 men 
aged 40-65 years. The primary goal was to determine the diagnosis of paroxysmal 
and/or perma-nent AF, which was followed by sleep apnoea screening (polygraphy) 
and erectile function evaluation (IIED-5 questionnaire).
RESULTS: Twenty-one (1.5%) patients with documented AF were identified. Based on 
the sleep-polygraphic studies, 14 (67%) of them had confirmation of OSA with 
mean apnoea-hypopnea index (AHI) equal to 27.5 ± 17.1. Furthermore, 11 (52%) 
patients met the OSAFED syndrome criteria. Patients with OSAFED syndrome had a 
mean score in IIEF-5 of 11.6 ± 3.5. The OSAFED-patients who were not diagnosed 
with all the of the syndrome components prior to the study-enrolment were 
characterised by substantially lower fat excess compared to their counterparts 
with already established OSAFED (body mass index: 30.1 ± 4.9 vs. 37.7 ± 3.9 
kg/m², respectively, p = 0.03).
CONCLUSIONS: Frequently coexisting OSAFED syndrome components in all AF patients 
from the primary care setting should encourage a more active search for OSA and 
ED in patients with any documented form of AF. Most of the studied patients did 
not have the diagnosis of OSA nor ED done prior to participation in the study.