Signal-averaged P wave area increases during respiratory events in patients with paroxysmal atrial fibrillation and obstructive sleep apnea
Autor: | Robert L. Abraham, Ken Monahan, Edward Hodges, Raghu Upender, Arpit Agrawal |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty Cardiac Volume Polysomnography Polysomnogram Atrial Function Right 03 medical and health sciences 0302 clinical medicine Reference Values Risk Factors Internal medicine Atrial Fibrillation Humans Medicine Wakefulness Respiratory system Oxygen saturation (medicine) Sleep Apnea Obstructive medicine.diagnostic_test business.industry Sleep apnea Atrial fibrillation Middle Aged medicine.disease Oxygen Obstructive sleep apnea Cross-Sectional Studies Cardiorespiratory Fitness 030228 respiratory system Otorhinolaryngology Cardiology Female Neurology (clinical) Sleep business 030217 neurology & neurosurgery Venous return curve |
Zdroj: | Sleep and Breathing. 23:1275-1281 |
ISSN: | 1522-1709 1520-9512 |
DOI: | 10.1007/s11325-019-01823-5 |
Popis: | P wave characteristics change during simulated apneic events in individuals with atrial fibrillation (AF). This study sought to assess whether similar changes occur during nocturnal respiratory events in patients with AF and obstructive sleep apnea (OSA). Thirty-five individuals with severe OSA who underwent formal polysomnography and subsequent AF ablation were compared to a matched group without AF. Electrocardiographic segments from each polysomnogram corresponding to the following events were identified: period of wakefulness closest to the initial onset of sleep (baseline-awake), first respiratory event, respiratory event with the lowest nadir oxygen saturation, longest respiratory event, and last respiratory event. Signal-averaged P wave duration and signal-averaged positive P wave area (amplitude*duration for positive P wave amplitudes) were extracted using custom software. P wave characteristics during respiratory events and the baseline-awake condition were compared. Compared to the baseline-awake condition, the signal-averaged positive P wave area was significantly greater during the longest event and the event with the lowest oxygen saturation in those with AF, but not in those without AF. There were no significant differences in signal-averaged P wave duration for any respiratory event compared to the baseline-awake condition, regardless of AF status. In patients with paroxysmal AF and obstructive sleep apnea, the signal-averaged positive P wave area is greater during certain respiratory events than during wakefulness. This finding may reflect the acute impact on right atrial volume of increased venous return associated with respiratory events and could be useful to assess AF risk in sleep apnea and to monitor response to treatment. |
Databáze: | OpenAIRE |
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