TY - JOUR
T1 - Severity of spleep apnea syndrome and life-threatening tachyarrhythmias in patients with implantable cardioverter defibrillator
AU - Bencardino, Gianluigi
AU - Vitulano, Nicola
AU - Bisignani, Antonio
AU - Gabrielli, Francesca Augusta
AU - Pelargonio, Gemma
AU - Narducci, Maria Lucia
AU - Perna, Francesco
AU - Pinnacchio, Gaetano
AU - Comerci, Gianluca
AU - Lanza, Gaetano Antonio
AU - Massetti, Massimo
AU - Crea, Filippo
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Death, Sudden, Cardiac
KW - Defibrillators, Implantable
KW - Female
KW - Humans
KW - Italy
KW - Male
KW - Middle Aged
KW - Polysomnography
KW - Primary Prevention
KW - Risk Factors
KW - Severity of Illness Index
KW - Sleep Apnea Syndromes
KW - Tachycardia, Ventricular
KW - implantable cardioverter defibrillator
KW - obstructive sleep apnea syndrome
KW - ventricular arrhythmias
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Death, Sudden, Cardiac
KW - Defibrillators, Implantable
KW - Female
KW - Humans
KW - Italy
KW - Male
KW - Middle Aged
KW - Polysomnography
KW - Primary Prevention
KW - Risk Factors
KW - Severity of Illness Index
KW - Sleep Apnea Syndromes
KW - Tachycardia, Ventricular
KW - implantable cardioverter defibrillator
KW - obstructive sleep apnea syndrome
KW - ventricular arrhythmias
UR - http://hdl.handle.net/10807/204745
U2 - 10.1111/pace.14328
DO - 10.1111/pace.14328
M3 - Article
SN - 0147-8389
VL - 44
SP - 1657
EP - 1662
JO - PACING AND CLINICAL ELECTROPHYSIOLOGY
JF - PACING AND CLINICAL ELECTROPHYSIOLOGY
ER -