The Effects of Continuous Positive Airway Pressure on Premature Ventricular Contractions and Ventricular Wall Stress in Patients with Heart Failure and Sleep Apnea.

Sabri Seyis,Adnan Kazım Usalan,Adil Can Gungen,Özge Kurmuş,Ibrahim Rencuzogullari

doi:10.1155/2018/2027061

Abstract

Background We aimed to investigate the effects of continuous positive airway pressure (CPAP) treatment on electrocardiography (ECG), premature ventricular contraction load on 24-hour Holter recordings, and implantable cardioverter defibrillator (ICD) shocks in patients with obstructive sleep apnea syndrome (OSAS) and heart failure. Methods Patients with heart failure and ICD and patients with newly diagnosed OSAS were divided into two groups according to CPAP treatment. To compare the impact of CPAP on ECG parameters, both baseline and 6-month ECG, 24-hour Holter ECG, ambulatory blood pressure monitoring, echocardiography, polysomnography, and laboratory parameters were collected. Results CPAP treatment significantly reduced the frequency of premature ventricular contractions, T-peak to T-end, corrected QT, corrected QT dispersion, and T-peak to T-end/corrected QT ratio in the study group (p < 0.001 for all). Although the baseline NT-pro-BNP levels were similar between study and control groups, after six months, the NT-pro-BNP levels of the study group were significantly lower than that of the control group (39.18 ± 7.57 versus 46.11 ± 7.65; p < 0.001). Conclusions CPAP treatment in patients with heart failure and ICD and in patients with newly diagnosed OSAS may have beneficial effects on premature ventricular contractions and electrocardiographic arrhythmia indices and NT-pro-BNP levels. However, these results are needed to be clarified with further studies.

Highlights

Obstructive sleep apnea syndrome (OSAS) is characterized by temporary airway collapse during sleep and affects more than 4% of men and 2% of women [1]
Fries et al [30] investigated the prognostic value of obstructive sleep apnea syndrome (OSAS) in congestive heart failure patients with implantable cardioverter defibrillator (ICD) implants and found that mortality rates were 44% in central sleep apnea and 13% in the absence of apnea at the 2 years of follow-up (p < 0.05), but this study found no association between sleep apnea and appropriate ICD therapy for VT or VF
We found reduced premature ventricular contraction rates after 6 months of continuous positive airway pressure (CPAP) treatment in patients with OSAS and heart failure compared to untreated controls

Summary

Introduction

Obstructive sleep apnea syndrome (OSAS) is characterized by temporary airway collapse during sleep and affects more than 4% of men and 2% of women [1]. Several studies reported that continuous positive airway pressure (CPAP) treatment in patients with congestive heart failure and OSAS reduced sympathetic activation and improved left. We aimed to investigate the effects of continuous positive airway pressure (CPAP) treatment on electrocardiography (ECG), premature ventricular contraction load on 24-hour Holter recordings, and implantable cardioverter defibrillator (ICD) shocks in patients with obstructive sleep apnea syndrome (OSAS) and heart failure. CPAP treatment in patients with heart failure and ICD and in patients with newly diagnosed OSAS may have beneficial effects on premature ventricular contractions and electrocardiographic arrhythmia indices and NT-pro-BNP levels. These results are needed to be clarified with further studies

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