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Compliance to CPAP treatment improves cardiac autonomic nervous system performance and electrical instability in patients with severe obstructive sleep apnea syndrome.

Session Poster session 3

Speaker Eftihia Simeonidou

Congress : EHRA 2017

  • Topic : arrhythmias and device therapy
  • Sub-topic : Arrhythmias, General - Pathophysiology and Mechanisms
  • Session type : Poster Session
  • FP Number : P1611

Authors : E Simeonidou (Athens,GR), C Vlami (Athens,GR), K Ntai (Athens,GR), C Koniari (Athens,GR), S Papiris (Athens,GR), J Lekakis (Athens,GR)

E Simeonidou1 , C Vlami2 , K Ntai1 , C Koniari1 , S Papiris2 , J Lekakis1 , 12nd University Cardiology Dept, Attikon Hospital - Athens - Greece , 2Attikon Hospital, Sleep Lab, Respiratory Medicinine Dept - Athens - Greece ,

Europace ( 2017 ) 19 ( Supplement 3 ), iii345

Purpose: It is well known that obstructive sleep apnea (OSAS) predisposes to cardiac arrhythmias with unpredictable consequences. Patients (pts) with OSAS have a higher incidence of sudden cardiac death as well. Autonomic nervous system modulation is implicated as the main mechanism. Heart rate turbulence (HRT) assessment is a reliable index of autonomic nervous system condition and prognostic marker of sudden cardiac death. In pts with severe OSAS and frequent ventricular ectopy we have already shown impaired HRT and significantly lower turbulence slope (TS). Aim of the study was to reassess HRT in the above group of pts after long-term uninterrupted use of continuous positive airway pressure (CPAP).

Methods: The study population consisted of 42 pts, (5 ? and 37?), mean age 53±9 years, diagnosed as significant OSAS (Apnea-hypopnea index-AHI =30/h) with frequent ventricular ectopy on 24h Holter monitoring (=60/h) and without significant heart disease. They underwent 24h Holter monitoring before initiation of continuous positive airway pressure (CPAP) and after 6 months time. HRT analysis with calculation of 2 parameters, turbulence onset (TO) and turbulence slope (TS) was performed followed by comparisons between the 2 groups. Abnormal values: TO>0, TS<2.5msec/RR. Ventricular ectopy burden was recorded and was correlated to HRT before and after CPAP.

Results: Only 13 pts of 42, 2? and 11?, (30%) demonstated increased adherence to CPAP. Significant negative correlation between TS and OSAS severity (AHI) (r = 0.51, p < 0.01) was found.  TO was higher and TS lower in the non-compliant group. TS was significantly lower in the compliant group before CPAP (1.80 ± 1.05 v 6.05 ± 2.2, p<0.01) and TS improvement was associated with ventricular ectopy elimination.

Conclusion: In OSAS pts, adherent to CPAP, with frequent ventricular ectopy and without underlying heart disease, significant improvement of HRT, mainly TS, was found associated with electrical stability.

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