Document Detail

Relationship among the severity of sleep apnea syndrome, cardiac arrhythmias, and autonomic imbalance.
MedLine Citation:
PMID:  12698666     Owner:  NLM     Status:  MEDLINE    
The relationship between obstructive sleep apnea syndrome (OSAS), cardiac arrhythmias, and conduction disturbances in adults remains controversial. Early studies showed a higher prevalence than more recent and designed epidemiological studies. To clarify the actual prevalence of cardiac arrhythmias and conduction disturbances in patients referred for assessment of OSAS, a prospective cohort study was conducted: 147 consecutive patients (103 men; mean age of 54.5 +/- 10.7 years) underwent time-synchronized polysomnography and ECG Holter monitoring. OSAS was diagnosed in 66 (44.9%) of them based on an apnea hypopnea index (AHI) > or = 10. Prevalence of heart failure, of prior myocardial infarction, of hypertension, and of ventricular arrhythmias were similar in patients with or without OSAS. Nocturnal paroxysmal asystole was significantly more prevalent in OSAS patients (10.6 vs 1.2%; P < 0.02) and the number of episodes of bradycardia and pauses increased with the severity of the syndrome. Almost all bradycardic events occurred in patients with severe OSAS (AHI > 30), prolonged periods of arterial oxyhemoglobin desaturation, and low diurnal awake PaO2. Moreover, using heart rate variability analysis, nocturnal sinusal dysfunction contrasted with a blunted diurnal parasympathetic modulation of the sinus node. Frequent nocturnal nonsustained supraventricular tachycardias were predominantly found in patients with severe sleep related breathing disorders; however, an increased risk of ventricular arrhythmias was not found. Under continuous positive airway pressure treatment, the 1-year follow-up of OSAS patients with nocturnal pauses did not reveal any arrhythmic event justifying a specific intervention.
Frédéric Roche; Alain Nguyen Thanh Xuong; Isabelle Court-Fortune; Frédéric Costes; Vincent Pichot; David Duverney; Jean-Michel Vergnon; Jean-Michel Gaspoz; Jean-Claude Barthélémy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-04-17     Completed Date:  2003-07-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  669-77     Citation Subset:  IM    
Service d'Exploration Fonctionnelle CardioRespiratoire, Laboratoire de Physiologie, GIP-ESS, CHU Nord, Faculté de Médecine Jacques Lisfranc Université Jean Monnet, Saint-Etienne, France.
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MeSH Terms
Arrhythmias, Cardiac / complications*,  diagnosis,  physiopathology
Autonomic Nervous System Diseases / complications*,  physiopathology
Electrocardiography, Ambulatory
Follow-Up Studies
Heart Conduction System / physiopathology
Middle Aged
Prospective Studies
Sleep Apnea, Obstructive / complications*,  diagnosis,  physiopathology
Time Factors

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