Severity of spleep apnea syndrome and life-threatening tachyarrhythmias in patients with implantable cardioverter defibrillator

Gianluigi Bencardino, Nicola Vitulano, Antonio Bisignani, Francesca Augusta Gabrielli, Gemma Pelargonio, Maria Lucia Narducci, Francesco Perna, Gaetano Pinnacchio, Gianluca Comerci, Gaetano Antonio Lanza, Massimo Massetti, Filippo Crea

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Background: Sleep apnea syndrome (SAS) has been reported to be associated with a higher incidence of ventricular arrhythmias. The aim of this study was twofold: (1) to investigate whether in SAS patients receiving an implantable cardioverter defibrillator (ICD) the severity of SAS was associated with the occurrence of ventricular arrhythmias; (2) to assess whether changes in nocturnal apnoic/hypopnoic episodes may favor the occurrence of life-threatening arrhythmias, that is, sustained ventricular tachycardia (VT)/fibrillation (VF), requiring ICD intervention. Methods: We enrolled 46 patients with documented SAS at polysomnography (apnea/hypopnea index [AHI] > 5) who also had a left ventricle ejection fraction (LVEF) < 35% and, according to primary prevention indications, implanted an ICD (Boston Scientific Incepta) able to daily monitor apnoic/hypopnoic episodes occurring during sleep. Patients were followed at 3-month intervals. Results: At a mean follow-up of 18 months, 21 episodes of sustained VT/FV requiring ICD intervention were documented in eight patients (17.4%). Baseline AHI was significantly higher in patients with compared to those without ICD intervention. ICD interventions, however, were not preceded by any worsening of apnoic/hypopnoic episodes. The respiratory disturbance index (RDI) of the week during the event, indeed, was not different from that recorded during the previous 2 weeks (25.4 ± 11, 25.6 ± 10 and 25.1 ± 10, respectively; p =.9). Conclusions: In patients with SAS who received an ICD for primary prevention of sudden death, those with ICD interventions showed a more severe form of the disease at baseline. ICD interventions, however, were not preceded by any significant changes in SAS severity.
Lingua originaleEnglish
pagine (da-a)1657-1662
Numero di pagine6
RivistaPACING AND CLINICAL ELECTROPHYSIOLOGY
Volume44
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Death, Sudden, Cardiac
  • Defibrillators, Implantable
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Polysomnography
  • Primary Prevention
  • Risk Factors
  • Severity of Illness Index
  • Sleep Apnea Syndromes
  • Tachycardia, Ventricular
  • implantable cardioverter defibrillator
  • obstructive sleep apnea syndrome
  • ventricular arrhythmias

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