Obstructive sleep apnoea

Abstract

In their Seminar on obstructive sleep apnoea,1Malhotra A White DP Obstructive sleep apnoea.Lancet. 2002; 360: 237-245Summary Full Text Full Text PDF PubMed Scopus (825) Google Scholar Atal Malhotra and David P White omit to mention the occurrence of arrhythmia, especially nocturnal bradyarrhythmia, as a common cardiovascular manifestation of this disorder. Severe sinus brady-cardia, high-grade atrioventricular block, and prolonged ventricular asystole have been described.2Stegman SS Burroughs JM Henthorn RW Asymptomatic bradyarrhythmias as a marker for sleep apnoea: appropriate recognition and treatment may reduce the need for pacemaker therapy.Pacing Clin Electrophysiol. 1996; 19: 899-904Crossref PubMed Scopus (72) Google Scholar In patients who have undergone electro-physiological assessment, sinus node function and atrioventricular conduction seem to be preserved.3Grimm W Hoffman J Menz V et al.Electrophysiologic evaluation of sinus node function and atrioventricular conduction in patients with prolonged ventricular asystole during obstructive sleep apnoea.Am J Cardiol. 1996; 15: 1310-1314Summary Full Text PDF Scopus (132) Google ScholarNocturnal arrhythmias have been shown to be markers of severe disease in obstructive sleep apnoea. Importantly, treatment of obstructive sleep apnoea by continuous positive airway pressure (CPAP) seems to abolish the arrhythmia and permanent pacing is not required.2Stegman SS Burroughs JM Henthorn RW Asymptomatic bradyarrhythmias as a marker for sleep apnoea: appropriate recognition and treatment may reduce the need for pacemaker therapy.Pacing Clin Electrophysiol. 1996; 19: 899-904Crossref PubMed Scopus (72) Google Scholar, 4Grimm W Koehler U Fus E et al.Outcome of patients with sleep apnoea-associated severe bradyarrhythmias after continuous positive airway pressure therapy.Am J Cardiol. 2000; 86: 688-692Summary Full Text Full Text PDF PubMed Scopus (113) Google Scholar The widespread availability of 24-h electro-cardiographic monitoring means that nocturnal arrhythmias could be the presenting feature of this disorder in patients under investigation of the somewhat vague symptoms associated with obstructive sleep apnoea or for other medical conditions. Physicians should be aware of this relation. In their Seminar on obstructive sleep apnoea,1Malhotra A White DP Obstructive sleep apnoea.Lancet. 2002; 360: 237-245Summary Full Text Full Text PDF PubMed Scopus (825) Google Scholar Atal Malhotra and David P White omit to mention the occurrence of arrhythmia, especially nocturnal bradyarrhythmia, as a common cardiovascular manifestation of this disorder. Severe sinus brady-cardia, high-grade atrioventricular block, and prolonged ventricular asystole have been described.2Stegman SS Burroughs JM Henthorn RW Asymptomatic bradyarrhythmias as a marker for sleep apnoea: appropriate recognition and treatment may reduce the need for pacemaker therapy.Pacing Clin Electrophysiol. 1996; 19: 899-904Crossref PubMed Scopus (72) Google Scholar In patients who have undergone electro-physiological assessment, sinus node function and atrioventricular conduction seem to be preserved.3Grimm W Hoffman J Menz V et al.Electrophysiologic evaluation of sinus node function and atrioventricular conduction in patients with prolonged ventricular asystole during obstructive sleep apnoea.Am J Cardiol. 1996; 15: 1310-1314Summary Full Text PDF Scopus (132) Google Scholar Nocturnal arrhythmias have been shown to be markers of severe disease in obstructive sleep apnoea. Importantly, treatment of obstructive sleep apnoea by continuous positive airway pressure (CPAP) seems to abolish the arrhythmia and permanent pacing is not required.2Stegman SS Burroughs JM Henthorn RW Asymptomatic bradyarrhythmias as a marker for sleep apnoea: appropriate recognition and treatment may reduce the need for pacemaker therapy.Pacing Clin Electrophysiol. 1996; 19: 899-904Crossref PubMed Scopus (72) Google Scholar, 4Grimm W Koehler U Fus E et al.Outcome of patients with sleep apnoea-associated severe bradyarrhythmias after continuous positive airway pressure therapy.Am J Cardiol. 2000; 86: 688-692Summary Full Text Full Text PDF PubMed Scopus (113) Google Scholar The widespread availability of 24-h electro-cardiographic monitoring means that nocturnal arrhythmias could be the presenting feature of this disorder in patients under investigation of the somewhat vague symptoms associated with obstructive sleep apnoea or for other medical conditions. Physicians should be aware of this relation.