Source: International Congress 2014 – The story continues: impact of OSA on cardiometabolic parameters
Disease area: Sleep and breathing disorders

Abstract

Sleep disordered breathing (SDB) is accompanied with increased risk to develop atrial dysrhythmia such as atrial fibrillation or atrial flutter, especially in heart failure patients. In this study we investigated SDB type and severity in patients with atrial dysrhythmias and we sought to determine an effect of successful cardioversion into sinus rhythm on SDB type and severity.We enrolled 81 patients prospectively for our study with heart failure symptoms subject to New York Heart Association (NYHA) functional classification II, III or IV. All patients underwent multichannel polygraphy for SDB diagnosis before and immediately (within 12 hours) after electrical cardioversion (CV) into sinus rhythm. All patients were invited to a four week follow up outpatient clinic visit to rescan for atrial dysrhythmia and SDB.A total of 95.5 % of patients with atrial dysrhythmia had SDB with a Apnea-Hypopnea-Index (AHI) of ³ 5/h; 40.7 % had obstructive SDB, 54.3 % had central SDB. Directly after cardioversion AHI was found significantly dropped down, from 22.9 ± 16.5 /h to 16.2 ± 11.1 /h, p<0.005). When scheduled for a four week follow-up, AHI was found back at similar levels than before CV (AHI 25.3 ± 15.4). 78.7 % maintained sinus rhythm in the outpatient setting at four weeks, 21.3 % developed atrial dysrhythmia reoccurrence.SDB was found at an unexpected high prevalence in HF patients with atrial dysrhythmia. Cardioversion into sinus rhythm improved SDB significantly, but SDB severity was found at comparable levels to initial investigations at a four week follow up.

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H. Fox, T. Bitter, D. Horstkotte, O. Oldenburg (Bad Oeynhausen, Germany). Atrial dysrhythmia control through cardioversion improves sleep disordered breathing in patients with heart failure. Eur Respir J 2014; 44: Suppl. 58, 1745

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