[Nocturnal heart rhythm disorder in patients with obstructive sleep apnea syndrome].

Objective: To explore the clinical characteristics of patients with obstructive sleep apnea syndrome (OSAS) and nocturnal arrhythmia.

Methods: During September 2010 to August 2011, a total of 446 subjects were recruited from Department of Sleep Breathing Disorder, Third Hospital, Hebei Medical University to receive polysomnography examination and electrocardiogram monitoring. According to the results, they were classified as mild (5 ≤ AHI < 15/h) or moderate (15 ≤ AHI < 40/h) or severe (AHI ≥ 40/h) OSAS. Then the incidence of different types of arrhythmias, risk factors and the relationship with OSAS severity were examined.

Results: Among 446 patients, the incidence of arrhythmia was 24.4% (109/446). The severity of OSAS (r = 1.857, P = 0.043) and age (r = 1.030, P = 0.003) had a positive relationship with the incidence of arrhythmias.Sinus bradycardia (79.8%, 87/109) and accidental ventricular premature beat (54.1%, 59/109) were most likely to occur than other types of arrhythmias (P < 0.01).In moderate and severity OSAS patients, the incidence of sinus bradycardia, frequent atrial premature beat, combined over two kinds of arrhythmias, atrial fibrillation and atrioventricular block were 50.0%, 0, 42.9%, 7.1%,0 and 90.9%, 14.8%, 57.9%, 4.5%, 5.7% respectively. And they were significantly higher than those of mild patients (all = 0) (all P < 0.05).

Conclusions: Age and severity of OSAS have a positive relationship with the incidence of nocturnal arrhythmias.Sinus bradycardia and ventricular premature beat are the most likely to occur in OSAS patients.In moderate and severe group, sinus bradycardia, frequent atrial premature beat, combined over two kinds of arrhythmias, atrial fibrillation and atrioventricular block are more commonly encountered.