Severe nocturnal bradycardia with daytime tachycardia in obstructive sleep apnoea

Bridgman, John C; Heddle, W F

doi:10.5694/j.1326-5377.2006.tb00133.x

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…A persistent increase in sympathetic tone due to oxygen desaturations and increases in arterial carbon dioxide levels can lead to electrical remodelling of atria facilitating supraventricular tachyarrhytmias 2. In such patients, treatment of OSAS may improve rhythm disturbances,2 5 and it has been reported in the literature that CPAP therapy in tachycardia–bradycardia syndrome has been beneficial 7. In our patient, who failed DCCV and had evidence of heart failure presumably due to uncontrolled AF, the only choice of therapy would have been to implant a pacemaker and either embark on a medical rate control or perform an atrioventricular node ablation.…”

Section: Discussionmentioning

confidence: 99%

Treatment of tachycardia: bradycardia syndrome in a patient with obstructive sleep apnoea

Lagan

Saravanan

2015

BMJ Case Reports

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SUMMARYObstructive sleep apnoea (OSAS) affects 4% of men and 2% of women aged 30-65 years. It is diagnosed in the presence of excessive daytime sleepiness and an apnoea-hypopnoea index (AHI) of ≥5 on polysomnography. Rhythm disturbances are common in OSAS and continuous positive airway pressure (CPAP) has been shown to be beneficial. We present a case of a patient with obesity, atrial fibrillation with fast ventricular response, significant nocturnal pauses (3.9 s) and tachycardiomyopathy. A polysomnography confirmed severe OSAS (AHI=64.25). CPAP improved bradycardia and allowed for the introduction of β-blockers. Subsequent Holter monitoring revealed better rate control with the longest pause of 2 s and the patient's left ventricular systolic function improved. CPAP prevented our patient from invasive treatment, allowed for rate control and improvement of tachycardiomyopathy. With such a high prevalence of OSAS, clinicians should be aware that CPAP may aid arrhythmia control. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Treatment of tachycardia: bradycardia syndrome in a patient with obstructive sleep apnoea

Lagan

Saravanan

2015

BMJ Case Reports

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Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities: Fig. 1—

Mr²

2006

Eur Respir J

788

479

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Considerable evidence is available in support of an independent association between obstructive sleep apnoea syndrome (OSAS) and cardiovascular disease, which is particularly strong for systemic arterial hypertension and growing for ischaemic heart disease, stroke, heart failure, atrial fibrillation and cardiac sudden death.The pathogenesis of cardiovascular disease in OSAS is not completely understood but likely to be multifactorial, involving a diverse range of mechanisms including sympathetic nervous system overactivity, selective activation of inflammatory molecular pathways, endothelial dysfunction, abnormal coagulation and metabolic dysregulation, the latter particularly involving insulin resistance and disordered lipid metabolism.The present report, which arose out of a European Union Cooperation in the field of Scientific and Technical Research (COST) action on OSAS (COST B26), reviews the current evidence for an independent association and proposes research priorities to identify the underlying mechanisms involved, with a view to identifying novel therapeutic strategies.Large-scale collaborative studies of carefully defined patient populations with obstructive sleep apnoea syndrome, adequately controlled for potential confounders, are needed. Such studies carry the prospect of evaluating potential interactions between different basic mechanisms operating in obstructive sleep apnoea syndrome and cardiovascular disease, and interactions with other related disorders, such as obesity, diabetes and dyslipidaemia. Furthermore, translational studies involving cell culture and animal models linked to studies of obstructive sleep apnoea syndrome patients are necessary to integrate basic mechanisms with the clinical disorder.

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Severe nocturnal bradycardia with daytime tachycardia in obstructive sleep apnoea

Cited by 2 publications

References 6 publications

Treatment of tachycardia: bradycardia syndrome in a patient with obstructive sleep apnoea

Treatment of tachycardia: bradycardia syndrome in a patient with obstructive sleep apnoea

Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities: Fig. 1—

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