Nocturnal cardiac arrhythmia in patients with obstructive sleep apnea

Olmetti, Francesca; Rovere, Maria Teresa La; Robbi, Elena; Taurino, Anna Eugenia; Fanfulla, Francesco

doi:10.1016/j.sleep.2007.08.015

Cited by 35 publications

(31 citation statements)

References 30 publications

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“…Another study showed similar results, with a prevalence of bradyarrhythmias of 8% in OSA patients with an AHI .30 events?h -1 compared with 2% in patients with an AHI ,30 events?h -1 [11]. Atrio-ventricular blocks, primarily grade II and III, are generally registered during rapid eye movement (REM) sleep when apnoeas are typically longer and oxygen desaturation is more pronounced, and have been reported to occur in about 10% of patients with OSA, compared with 1% in the healthy elderly population [23,73,75].…”

Section: Bradycardia Sinus Pauses and Atrio-ventricular Blocksmentioning

confidence: 57%

“…However, this is in contrast to MILLER [96] who reviewed 24 h Holter ECGs of 23 patients with OSA, and found that the prevalence of VPCs and ventricular arrhythmias during sleep is not different when compared to wakefulness [96]. In a more recent study, ECG data from 257 patients with newly diagnosed OSA were analysed [11]. Only 9% of patients had VPCs and no correlation with OSA severity was found [11].…”

Section: Ventricular Arrhythmias Observational Studiesmentioning

confidence: 91%

“…In a more recent study, ECG data from 257 patients with newly diagnosed OSA were analysed [11]. Only 9% of patients had VPCs and no correlation with OSA severity was found [11]. Because of these conflicting findings it is uncertain whether ventricular arrhythmias are more frequently observed in patients with OSA than in comparable populations.…”

Section: Ventricular Arrhythmias Observational Studiesmentioning

confidence: 99%

“…OSA has mainly been associated with premature atrial complex short runs, sinus bradycardia, sinus pauses, premature ventricular complexes and paroxysmal atrial fibrillation [9][10][11], while central sleep apnoea (CSA) has mainly been associated with atrial fibrillation [12]. There is also evidence for a close temporal relationship between arrhythmia and obstructive apnoeas [13].…”

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confidence: 99%

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Effects of obstructive sleep apnoea on heart rhythm

2012

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Symptomatic obstructive sleep apnoea (OSA) has been proven to be a risk factor for hypertension and vascular dysfunction, and has been proposed to be causally related with cardiac arrhythmias and sudden cardiac death.Searches of bibliographical databases revealed that several mechanisms seem to underpin the association between OSA and cardiac arrhythmias: intermittent hypoxia associated with autonomic nervous system activation and increased oxidative stress, which may lead to cardiac cellular damage and alteration in myocardial excitability; recurrent arousals, resulting in sympathetic activation and coronary vasoconstriction; and increased negative intrathoracic pressure which may mechanically stretch the myocardial walls and, thus, promote acute changes in myocardial excitability as well as structural remodelling of the myocardium.Findings from cross-sectional studies suggest a high prevalence of cardiac arrhythmias in patients with OSA and a high prevalence of OSA in those with cardiac arrhythmias. Preliminary evidence from uncontrolled interventional studies suggests that treatment of OSA may prevent cardiac arrhythmias.In conclusion, there is preliminary evidence that OSA is associated with the development of cardiac arrhythmias. Data from randomised controlled studies are needed to definitively clarify the role of OSA in arrhythmogenesis.

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Section: Bradycardia Sinus Pauses and Atrio-ventricular Blocksmentioning

confidence: 57%

Section: Ventricular Arrhythmias Observational Studiesmentioning

confidence: 91%

Section: Ventricular Arrhythmias Observational Studiesmentioning

confidence: 99%

mentioning

confidence: 99%

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Effects of obstructive sleep apnoea on heart rhythm

2012

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“…Almost half (47%) were shown to have severe cardiac rhythm disturbances, of whom all but 2 had severe bradycardia. In a study of 247 patients with OSAS who had been referred for polysomnography who were shown to have an AHI >=5 and daytime symptoms, 46 (18.6%) had rhythm disturbances during sleep (Olmetti et al, 2008). Tachyarrhythmias occurred in 35 (14.2%) and bradyarrhythmias in 11 (4.4%) patients.…”

Section: Cardiac Arrhythmias In Community-based Studies and In Subjecmentioning

confidence: 99%

Sleep-Related Breathing Disorders and Cardiac Arrhythmia

Hersi¹

2012

Cardiac Arrhythmias - New Considerations

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Is obstructive sleep apnea associated with ventricular tachycardia? A retrospective study from the National Inpatient Sample and a literature review on the pathogenesis of Obstructive Sleep Apnea

Salama

Abdullah

Wahab

et al. 2018

Clinical Cardiology

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Background Obstructive sleep apnea (OSA) is a known independent risk factor for a multiple cardiovascular morbidities and mortality. The association of OSA and ventricular arrhythmias is less well understood. The aim of this analysis is to study the relationship between OSA and ventricular tachyarrhythmias. Hypothesis OSA is associated with increased ventricular arrhythmias. Methods Data from the national inpatient sample (NIS) 2012 to 2014, were reviewed. Discharges associated with OSA were identified as the target population using the relevant ICD‐9‐CM codes. The primary outcome was a diagnosis of ventricular tachycardia (VT) in the OSA population. Secondary outcomes include the rate of ventricular fibrillation (VF) and cardiac arrest. Multivariable analyses were performed to examine the association of VT with multiple potential confounding clinical variables. Results Of 18 013 878 health encounters, 943 978 subjects (5.24%) had a diagnosis of OSA. VT and VF were more prevalent among patients with OSA compared to those without a diagnosis of OSA (2.24% vs 1.16%; P < 0.001 and 0.3% vs 0.2%; P < 0.001, respectively). Odds ratio for cardiac arrest in OSA group was not statistically significant (1, 95% confidence interval 0.97‐1.02, P < 0.76). In unadjusted analyses, all examined comorbidities were significantly more common in those with OSA, including diabetes mellitus, hypertension, chronic kidney disease, acute coronary syndrome, and heart failure. Conclusion OSA is associated with increased rates of ventricular tachyarrhythmia.

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Nocturnal cardiac arrhythmia in patients with obstructive sleep apnea

Cited by 35 publications

References 30 publications

Effects of obstructive sleep apnoea on heart rhythm

Effects of obstructive sleep apnoea on heart rhythm

Sleep-Related Breathing Disorders and Cardiac Arrhythmia

Is obstructive sleep apnea associated with ventricular tachycardia? A retrospective study from the National Inpatient Sample and a literature review on the pathogenesis of Obstructive Sleep Apnea

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