Nocturnal cardiac arrhythmia in patients with obstructive sleep apnea
| Autor: | Elena Robbi, Anna Eugenia Taurino, Francesco Fanfulla, Maria Teresa La Rovere, Francesca Olmetti |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Polysomnography Autonomic Nervous System Hypoxemia Pulmonary Disease Chronic Obstructive Risk Factors Internal medicine medicine Humans Hypoxia Aged Sleep Apnea Obstructive COPD medicine.diagnostic_test business.industry Snoring Sleep apnea Apnea Cardiac arrhythmia Arrhythmias Cardiac General Medicine Adrenergic beta-Agonists Middle Aged medicine.disease nervous system diseases respiratory tract diseases Oxygen Obstructive sleep apnea Cardiology Female medicine.symptom business Hypopnea |
| Zdroj: | Sleep Medicine. 9:475-480 |
| ISSN: | 1389-9457 |
| DOI: | 10.1016/j.sleep.2007.08.015 |
| Popis: | Background and purpose Nocturnal cardiac arrhythmias occur in patients with obstructive sleep apnea (OSA), reportedly as a consequence of the autonomic effects of recurrent apnea with subsequent oxygen desaturation. We have investigated whether different patterns of OSA are associated with specific arrhythmia during sleep. Patients and methods Electrocardiographic (ECG) data recorded during polysomnography (PSG) were analysed in 257 consecutive OSA patients to determine the prevalence of cardiac rhythm disturbances, and to relate these to breathing pattern (normal, apnea/hypopnea, recovering ventilation, snoring) and oxygen saturation. Results Arrhythmias were found in 18.5% of patients. Patients with nocturnal bradyarrhythmia (BA) had higher values of ventilatory disturbance (apnea–hypopnea index [AHI] 58.8±36.8 vs 37.2±30.3, p =0.02), mean desaturation amplitude (8.9±4 vs 5.9±3.4%, p =0.03), and a lower SaO 2 nadir (69% vs 77%, p = 0.003) than those without arrhythmia. The prevalence of BA in patients with AHI⩾ 30/h was significantly higher than that observed in those with AHI χ 2 =5.61, p =0.01). In contrast, patients with tachyarrhythmia (TA) had no significant differences in AHI, mean desaturation amplitude or SaO 2 nadir than those without arrhythmia. No associations were found between arrhythmia and the presence of comorbidity or concomitant medical therapy, except for an association between tachyarrhythmia and chronic obstructive pulmonary disease (COPD) (odds ratio 2.53; 95% confidence intervals 1.1–5.8, p =0.03). Conclusions We conclude that while BA during sleep is associated with OSA severity, concomitant COPD or β 2 -treatment may play a role in the development of TA during sleep. |
| Databáze: | OpenAIRE |
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