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Characteristics and circadian distribution of cardiac arrhythmias in patients with heart failure and sleep-disordered breathing
- Source :
- Clinical research in cardiology : official journal of the German Cardiac Society. 107(10)
- Publication Year :
- 2018
-
Abstract
- Cardiac arrhythmias and sleep-disordered breathing (SDB) are common comorbidities in heart failure with reduced ejection fraction (HFrEF). However, understanding of the association between arrhythmias and SDB is poor. This study assessed the occurrence and circadian distribution of ventricular arrhythmias in HFrEF patients with and without SDB. This retrospective analysis included HFrEF patients admitted for unattended overnight cardiorespiratory polygraphy and 24-h Holter-ECG recording. Holter-ECG data (events/h) were categorized by time of day: morning, 06:00–13:59; afternoon, 14:00–21:59; nighttime, 22:00–05:59. Respiratory events were expressed using the apnea–hypopnea index (AHI) and an AHI ≥ 15/h was categorized as moderate to severe SDB. 167 patients were included (82% male, age 65 ± 10.4 years, left ventricular ejection fraction 30.9 ± 7.9%); SDB was predominantly central sleep apnea (CSA) in 45.5%, obstructive sleep apnea (OSA) in 23.9% or none/mild (nmSDB) in 17.4%. Morning premature ventricular contractions (PVCs) were detected significantly more frequently in CSA versus nmSDB patients (44.4/h versus 1.8/h; p = 0.02). Non-sustained VT was more frequent in patients with CSA versus versus OSA or nmSDB (17.9 versus 3.2 or 3.2%/h; p = 0.003 and p = 0.005, respectively). There was no significant variation in VT occurrence by time of day in HFrEF patients with CSA (p = 0.3). CSA was an independent predictor of VT occurrence in HFrEF in multivariate logistic regression analysis (odds ratio 4.1, 95% confidence interval 1.5–11.4, p = 0.007). CSA was associated with VT occurrence irrespective of sleep/wake status in HFrEF patients, and independently predicted the occurrence of VT. This association may contribute to chances by which CSA increases sudden death risk in HFrEF patients.
- Subjects :
- Male
medicine.medical_specialty
Central sleep apnea
Polysomnography
Comorbidity
030204 cardiovascular system & hematology
Sudden death
Ventricular Function, Left
03 medical and health sciences
0302 clinical medicine
Sleep Apnea Syndromes
Heart Rate
Internal medicine
Germany
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Aged
Retrospective Studies
Heart Failure
Ejection fraction
business.industry
Sleep apnea
Cardiorespiratory fitness
Stroke Volume
General Medicine
Odds ratio
Middle Aged
medicine.disease
Prognosis
respiratory tract diseases
Circadian Rhythm
Obstructive sleep apnea
Heart failure
Cardiology
Electrocardiography, Ambulatory
Tachycardia, Ventricular
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 18610692
- Volume :
- 107
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Clinical research in cardiology : official journal of the German Cardiac Society
- Accession number :
- edsair.doi.dedup.....a92cf68f225bc888ea0f6335633b5baa