AI Article Synopsis
- Sleep-disordered breathing (SDB) is linked to higher rates of dangerous ventricular arrhythmias in patients with pre-existing heart conditions, particularly during sleep.
- A study involving 45 patients with implantable cardioverter-defibrillators (ICDs) found that 57.8% had SDB, and those with SDB experienced more appropriate ICD therapies (73% vs. 47%).
- The risk for these life-threatening arrhythmias was significantly greater for patients with SDB during nighttime (midnight to 6 AM), suggesting the need for SDB screening in patients with nocturnal arrhythmia patterns.
Article Abstract
Background: Sleep-disordered breathing (SDB) has been associated with various benign cardiac arrhythmias occurring during sleep.
Objective: The purpose of this study was to demonstrate that SDB contributes to the development of life-threatening ventricular arrhythmias in patients with an established arrhythmic substrate.
Methods: We prospectively studied the association between SDB and timing of life-threatening ventricular arrhythmic events in 45 patients with an implantable cardioverter-defibrillator (ICD). SDB was defined as an apnea-hypopnea index (AHI) >10 events/hour based on an overnight sleep study. The primary outcome measure was appropriate ICD therapy, defined as antitachycardia pacing or shock for ventricular tachycardia or ventricular fibrillation during 1-year follow-up.
Results: SDB was present in 26 (57.8%) patients. Appropriate ICD therapies were higher among patients with SDB (73% vs 47%, P = .02). Logistic regression identified SDB as a predictor of any appropriate ICD therapy (odds ratio 4.4, 95% confidence interval 1.4-15.3, P = .01). The risk for ventricular arrhythmias was higher in patients with SDB solely due to an increase in events occurring between midnight and 6 AM (odds ratio 5.6, 95% confidence interval 2.0-15.6, P = .001) with no discernible effect on appropriate ICD therapy during nonsleeping hours (odds ratio 0.7, 95% confidence interval 0.2-2.3, P = .61).
Conclusion: Patients with an ICD and SDB have a striking increase in the onset of life-threatening ventricular arrhythmic events during sleeping hours. These findings provide a rationale for SDB screening in patients with appropriate ICD therapy if device interrogation reveals a predominance of nocturnal onset of arrhythmias.
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| http://dx.doi.org/10.1016/j.hrthm.2010.12.030 | DOI Listing |
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