Cardiac rhythm in patients with sleep-disordered breathing and coronary artery disease.

Abstract

We examined the effect of sleep-disordered breathing on heart rates and arrhythmias in men and women with disabling angina pectoris and verified coronary artery disease by an overnight sleep study and Holter recording. The number of oxyhaemoglobin desaturations > or =4% (ODI) and number of apnoea-hypopnoeas per hour of sleep (AHI) were recorded. ODI > or =5 and AHI > or =10 were used as measures of disordered breathing and patients below these limits formed the control groups. One-hundred and forty-one men and 98 women < or =70 years of age were randomly included. Thirty-eight percent of the men and 36% of the women had an ODI > or =5. No serious ventricular arrhythmias occurred. Women with disordered breathing (ODI > or =5) had higher heart rates (mean 63.3 vs 59.1, p < 0.05) and a higher occurrence of ventricular premature contractions (VPCs) during sleep (75th percentiles 2.5 vs 0.5 per hour, p < 0.01). In men, however, no significant association between disordered breathing and heart rates or arrhythmias was found. We conclude that serious arrhythmias are infrequent in unselected patients with coronary artery disease and mild to moderate sleep-disordered breathing. Disordered breathing in women is associated with higher heart rates and a higher occurrence of VPCs during sleep.