<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Background</h3><p>Cardiac arrhythmias represent one of the consequences of obstructive sleep apnea (OSA). The gold standard of moderate–severe symptomatic OSA treatment is positive pressure therapy [continuous positive airway pressure (CPAP)]. The use of CPAP in patients with cardiac arrhythmias and OSA may contribute to the maintenance of sinus rhythm.</p></sec><sec><h3>Aim</h3><p>To assess the effects of the CPAP therapy in addition to pharmacological and/or ablative interventions in maintaining the sinus rhythm in patients with cardiac arrhythmias and moderate–severe OSA.</p></sec><sec><h3>Materials and methods</h3><p>Patients diagnosed with cardiac arrhythmias [atrial fibrillation (AF)/flutter] and high pretest OSA suspicion (at least two items out of the following: snoring, witnessed apneas, obesity and excessive daytime sleepiness), performed a cardiorespiratory polygraphy (nasal flowmetry, pulse oximetry, thoracoabdominal movements, snoring and body position) for positive diagnosis and OSA severity assessment. Patients with moderate–severe OSA underwent CPAP titration with consecutive therapy indication (CPAP therapy plus pharmacological and/or ablative intervention). At 1 year, patients who used CPAP (group A) and those without CPAP (group B) were re-evaluated for the presence or absence of cardiac arrhythmias.</p></sec><sec><h3>Results</h3><p>Sixty-three patients with AF/flutter and high pretest suspicion of OSA performed cardiorespiratory polygraphy. Sixty patients (39 men) were diagnosed with OSA, out of which 40 (26 men) had moderate–severe OSA (apnea–hypopnea index, AHI ≥ 15/h) and underwent CPAP titration. At 1 year of follow-up, 17 patients (42.5%) were found adherent to the CPAP therapy (group A) and 23 (57.5%) did not use CPAP (group B). The two groups were similar in terms of age, body mass index, daytime sleepiness (assessed by Epworth Sleepiness Scale) and oxygen desaturation index, and statistically significant differences were recorded for the values of AHI and the time spent below SaO2 &lt;90% (t90%), statistically significant higher (p &lt; 0.01, respectively p &lt; 0.04) in group A compared to group B. At 1 year, in group A, more patients had sinus rhythm compared to those with AF/flutter (13, respectively 4). In group B, 8 patients were in sinus rhythm and 15 with AF/flutter.</p></sec><sec><h3>Conclusions</h3><p>The CPAP therapy added to standard therapy (pharmacological therapy and/or ablative procedures) in patients with moderate–severe OSA and installed cardiovascular disease (arrhythmias) has a favourable effect on maintaining the sinus rhythm at 1 year of follow-up.</p></sec></abstract>

BackgroundCardiac arrhythmias represent one of the consequences of obstructive sleep apnea (OSA). The gold standard of moderate–severe symptomatic OSA treatment is positive pressure therapy [continuous positive airway pressure (CPAP)]. The use of CPAP in patients with cardiac arrhythmias and OSA may contribute to the maintenance of sinus rhythm.AimTo assess the effects of the CPAP therapy in addition to pharmacological and/or ablative interventions in maintaining the sinus rhythm in patients with cardiac arrhythmias and moderate–severe OSA.Materials and methodsPatients diagnosed with cardiac arrhythmias [atrial fibrillation (AF)/flutter] and high pretest OSA suspicion (at least two items out of the following: snoring, witnessed apneas, obesity and excessive daytime sleepiness), performed a cardiorespiratory polygraphy (nasal flowmetry, pulse oximetry, thoracoabdominal movements, snoring and body position) for positive diagnosis and OSA severity assessment. Patients with moderate–severe OSA underwent CPAP titration with consecutive therapy indication (CPAP therapy plus pharmacological and/or ablative intervention). At 1 year, patients who used CPAP (group A) and those without CPAP (group B) were re-evaluated for the presence or absence of cardiac arrhythmias.ResultsSixty-three patients with AF/flutter and high pretest suspicion of OSA performed cardiorespiratory polygraphy. Sixty patients (39 men) were diagnosed with OSA, out of which 40 (26 men) had moderate–severe OSA (apnea–hypopnea index, AHI ≥ 15/h) and underwent CPAP titration. At 1 year of follow-up, 17 patients (42.5%) were found adherent to the CPAP therapy (group A) and 23 (57.5%) did not use CPAP (group B). The two groups were similar in terms of age, body mass index, daytime sleepiness (assessed by Epworth Sleepiness Scale) and oxygen desaturation index, and statistically significant differences were recorded for the values of AHI and the time spent below SaO2 <90% (t90%), statistically significant higher (p < 0.01, respectively p < 0.04) in group A compared to group B. At 1 year, in group A, more patients had sinus rhythm compared to those with AF/flutter (13, respectively 4). In group B, 8 patients were in sinus rhythm and 15 with AF/flutter.ConclusionsThe CPAP therapy added to standard therapy (pharmacological therapy and/or ablative procedures) in patients with moderate–severe OSA and installed cardiovascular disease (arrhythmias) has a favourable effect on maintaining the sinus rhythm at 1 year of follow-up.

Obstructive sleep apnea, cardiac arrhythmias and continuous positive airway pressure therapy: one-year follow-up

“Carol Davila” University of Medicine and Pharmacy

“Carol Davila” Emergency University Military Hospital

Pneumologia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Apneea in somn de tip obstructiv, aritmiile cardiace si efectul la un an al terapiei cu presiune pozitiva

BackgroundCardiac arrhythmias represent one of the consequences of obstructive sleep apnea (OSA). The gold standard of moderate–severe symptomatic OSA...

Obstructive sleep apnea, cardiac arrhythmias and continuous positive airway pressure therapy: one-year follow-up

Article Category: Original Papers

Publié en ligne: 27 juil. 2020

Pages: 47 - 52

DOI: https://doi.org/10.2478/pneum-2020-0005

Mots clés
obstructive sleep apnea, cardiac arrhythmias, CPAP therapy

© 2020 Liliana Alexandrina Grigoriu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Figure 2

Figure 3

Characteristics of Group B

Characteristics of the patients with moderate/severe OSA

Characteristics of Group A

Obstructive sleep apnea, cardiac arrhythmias and continuous positive airway pressure therapy: one-year follow-up

Article Category: Original Papers

Publié en ligne: 27 juil. 2020

Pages: 47 - 52

DOI: https://doi.org/10.2478/pneum-2020-0005

Mots clésobstructive sleep apnea, cardiac arrhythmias, CPAP therapy

© 2020 Liliana Alexandrina Grigoriu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Figure 2

Figure 3

Characteristics of Group B

Characteristics of the patients with moderate/severe OSA

Characteristics of Group A

Mots clés
obstructive sleep apnea, cardiac arrhythmias, CPAP therapy