Publication: Triggering of Nocturnal Arrhythmias by Sleep-Disordered Breathing Events
No Thumbnail Available
Date
2009-11-03
Published Version
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier BV
The Harvard community has made this article openly available. Please share how this access benefits you.
Citation
Monahan, Ken, Amy Storfer-Isser, Reena Mehra, Eyal Shahar, Murray Mittleman, Jeff Rottman, Naresh Punjabi et al. "Triggering of Nocturnal Arrhythmias by Sleep-Disordered Breathing Events." Journal of the American College of Cardiology 54, no. 19 (2009): 1797-1804. DOI: 10.1016/j.jacc.2009.06.038
Research Data
Abstract
Objectives
This study sought to evaluate respiratory disturbances as potential triggers for arrhythmia in those with sleep-disordered breathing (SDB).
Background
SDB is associated with increased risk of atrial fibrillation (AF) and non-sustained ventricular tachycardia (NSVT) as well as a predilection for sudden cardiac death during nocturnal sleeping hours. However, prior research has not established whether respiratory disturbances operate as triggers for nocturnal arrhythmias.
Methods
Overnight polysomnograms (PSGs) from the Sleep Heart Health Study (n = 2816) were screened for paroxysmal atrial fibrillation (PAF) and NSVT. We used the case-crossover design to determine whether apneas and/or hypopneas are temporally associated with episodes of PAF or NSVT. For each arrhythmia, 3 periods of sinus rhythm were identified as control intervals. PSGs were examined for the presence of respiratory disturbances, oxygen desaturations, and cortical arousals within a 90-second hazard period preceding each arrhythmia or control period.
Results
Fifty-seven participants with a wide range of SDB contributed 62 arrhythmias (76% NSVT). The odds of an arrhythmia following a respiratory disturbance were nearly 18-times (OR 17.5; 95% CI 5.3–58.4) the odds of an arrhythmia occurring following normal breathing. The absolute rate of arrhythmia associated with respiratory disturbances was low (1 excess arrhythmia/40000 respiratory disturbances). Neither hypoxia nor EEG-defined arousals alone increased arrhythmia risk.
Conclusions
Although the absolute arrhythmia rate is low, the relative risk of PAF and NSVT during sleep is markedly increased shortly after a respiratory disturbance. These results support a direct temporal link between SDB events and the development of these arrhythmias.
Description
Other Available Sources
Keywords
Research Subject Categories::MEDICINE::Dermatology and venerology,clinical genetics, internal medicine::Internal medicine::Cardiology
Terms of Use
This article is made available under the terms and conditions applicable to Other Posted Material (LAA), as set forth at Terms of Service