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Sleep-disordered breathing increased arrhythmias in patients with ICDs
Zeidan-Shwiri T. Heart Rhythm. 2011;8:657-662.
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A study in the journal Heart Rhythm has found that patients with implantable cardioverter defibrillators who had sleep-disordered breathing were at significantly higher risk for ventricular arrhythmias compared with those without sleep-disordered breathing.
The prospective study involved 45 patients with an ICD who were enrolled from August 2007 to March 2009. Twenty-six of these patients had sleep-disordered breathing (SDB), defined as an apnea-hypopnea index of morethan 10 events per hour as determined by an overnight sleep study. The current study’s primary endpoint was appropriate ICD therapy during a 1-year follow-up.
During this time, 62% of patients had one or more episodes of ventricular fibrillation or ventricular tachycardia. Researchers reported a higher rate of appropriate ICD therapies in patients with SDB vs. those without (73% vs. 47%; P=.02), with further analysis proving SDB to be a predictor of any ICD therapy (OR=4.4; P=.01). Cited as the cause of the increased risk for ventricular arrhythmias in patients with SDB was the increase in events that occurred between midnight and 6 a.m. (OR=5.6; P=.001), which was not seen during non-sleeping hours.
“These findings provide a rationale for SDB screening in patients with appropriate ICD therapy if device interrogation reveals a predominance of nocturnal onset of arrhythmias,” the researchers concluded. “Future studies are warranted to evaluate whether treatment of SDB reduces the risk of appropriate ICD therapy.”
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