Email this article Ventricular arrhythmias in a patient with obstructive sleep apnea syndrome and its effective non-pharmaceutical treatment
- Authors: Palman A.D.1, Akselrod A.S.1
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Affiliations:
- I.M. Sechenov First Moscow State Medical University
- Issue: Vol 49, No 2 (2021)
- Pages: 165-170
- Section: CLINICAL CASES
- URL: https://almclinmed.ru/jour/article/view/1502
- DOI: https://doi.org/10.18786/2072-0505-2021-49-031
- ID: 1502
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Abstract
Patients with obstructive sleep apnea syndrome (OSAS) are characterized by various cardiac arrhythmias during sleep. However, while the association between OSAS and atrial fibrillation is considered proven, the presence of a pathophysiological link between sleep apnea and ventricular arrhythmias remains a matter of debate.
We present a case of a 51-year old man with arterial hypertension and type 2 diabetes who was referred for sleep assessment after being diagnosed with predominantly nocturnal cardiac arrhythmias. Overnight cardiorespiratory monitoring showed that the patient had a severe OSAS with an apnea-hypopnea index of 57 per hour and a minimal SpO2 during sleep of 73%. On the channel of electrocardiogram (ECG) frequent single monomorphic ventricular extrasystoles, eventually of the bigeminal type, and one short paroxysm of a wide-complex regular rhythm of 60 beats per minute (accelerated idioventricular rhythm) associated with prolonged apnea were identified. Continuous airway positive pressure (CPAP) therapy was started which was able to control for breathing disorders during sleep. At the follow-up 24-hours Holter ECG monitoring, the numbers of ventricular extrasystoles during sleep decreased 2-fold, without any idioventricular rhythm episodes.
The clinical case clearly illustrates that in some patients with OSAS, first of all, in those with severe OSAS and comorbid cardiovascular disorders, breathing disorders during sleep can trigger ventricular arrhythmias. In such patients, CPAP therapy could both improves their quality of life and provide an indirect antiarrhythmic effect.
About the authors
A. D. Palman
I.M. Sechenov First Moscow State Medical University
Author for correspondence.
Email: doctorpalman@mail.ru
ORCID iD: 0000-0002-3665-4044
Alexander D. Palman – MD, PhD, Associate Professor, Chair of Hospital Therapy No. 1, Institute of Clinical Medicine named after N.V. Sklifosovskiy
8/2 Trubetskaya ul., Moscow, 119991, Russian Federation
РоссияA. S. Akselrod
I.M. Sechenov First Moscow State Medical University
Email: fake@neicon.ru
ORCID iD: 0000-0003-3417-794X
Anna S. Akselrod – MD, PhD, Professor, Chair of Cardiology, Functional and Ultrasound Diagnostics, Institute of Clinical Medicine named after N.V. Sklifosovskiy
8/2 Trubetskaya ul., Moscow, 119991, Russian Federation
РоссияReferences
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