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Does obstructive sleep apnoea modulate cardiac autonomic function in paroxysmal atrial fibrillation?

PURPOSE: The autonomic nervous system may mediate acute apnoea–induced atrial fibrillation (AF). We compared cardiac autonomic function in paroxysmal atrial fibrillation (PAF) patients with and without obstructive sleep apnoea (OSA). METHODS: Case control study of 101 patients with PAF recruited at...

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Autores principales: Mohammadieh, Anna Mary, Dissanayake, Hasthi U., Sutherland, Kate, Ucak, Seren, De Chazal, Philip, Cistulli, Peter A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172286/
https://www.ncbi.nlm.nih.gov/pubmed/35397040
http://dx.doi.org/10.1007/s10840-022-01202-3
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author Mohammadieh, Anna Mary
Dissanayake, Hasthi U.
Sutherland, Kate
Ucak, Seren
De Chazal, Philip
Cistulli, Peter A.
author_facet Mohammadieh, Anna Mary
Dissanayake, Hasthi U.
Sutherland, Kate
Ucak, Seren
De Chazal, Philip
Cistulli, Peter A.
author_sort Mohammadieh, Anna Mary
collection PubMed
description PURPOSE: The autonomic nervous system may mediate acute apnoea–induced atrial fibrillation (AF). We compared cardiac autonomic function in paroxysmal atrial fibrillation (PAF) patients with and without obstructive sleep apnoea (OSA). METHODS: Case control study of 101 patients with PAF recruited at two tertiary centres. All patients underwent in-laboratory polysomnography. ECG signal demonstrating “steady state” sinus rhythm (i.e. with arrhythmic beats and respiratory events excluded) was included in the analysis. Cardiac autonomic function was assessed via measures of heart rate variability (HRV) and reported by sleep stage (REM vs Non-REM) for patients with and without OSA. RESULTS: Sixty-five (66.3%) of patients were male, mean age 61.5 ± 11.6 years, mean BMI 27.1 ± 4.3 kg/m(2). Global measures of HRV (triangular index, total power) did not differ between PAF patients with and without OSA in either REM or non-REM sleep. Frequency-domain analysis during non-REM sleep in PAF patients with OSA showed increased cardiac parasympathetic modulation (HF-nu: 39.1 ± 15.7 vs 48.0 ± 14.6, p = 0.008) and reduced cardiac sympathetic modulation (LF-nu 54.1 ± 19.7 vs 43.7 ± 18.0, p = 0.012, LF/HF ratio: 2.1 ± 2.0 vs 1.2 ± 1.0, p = 0.007). Results remained significant after adjusting for age, sex, and BMI (adjusted p values 0.024, 0.045 and 0.018 respectively). There were no differences in HRV parameters during REM sleep. CONCLUSIONS: This is the first study of HRV in PAF patients with and without OSA. Our results indicate limited differences in HRV between groups. However, this work suggests a chronic increase in parasympathetic nervous modulation and relative reduction in sympathetic modulation in PAF patients with OSA during steady-state non-REM sleep. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10840-022-01202-3.
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spelling pubmed-101722862023-05-12 Does obstructive sleep apnoea modulate cardiac autonomic function in paroxysmal atrial fibrillation? Mohammadieh, Anna Mary Dissanayake, Hasthi U. Sutherland, Kate Ucak, Seren De Chazal, Philip Cistulli, Peter A. J Interv Card Electrophysiol Article PURPOSE: The autonomic nervous system may mediate acute apnoea–induced atrial fibrillation (AF). We compared cardiac autonomic function in paroxysmal atrial fibrillation (PAF) patients with and without obstructive sleep apnoea (OSA). METHODS: Case control study of 101 patients with PAF recruited at two tertiary centres. All patients underwent in-laboratory polysomnography. ECG signal demonstrating “steady state” sinus rhythm (i.e. with arrhythmic beats and respiratory events excluded) was included in the analysis. Cardiac autonomic function was assessed via measures of heart rate variability (HRV) and reported by sleep stage (REM vs Non-REM) for patients with and without OSA. RESULTS: Sixty-five (66.3%) of patients were male, mean age 61.5 ± 11.6 years, mean BMI 27.1 ± 4.3 kg/m(2). Global measures of HRV (triangular index, total power) did not differ between PAF patients with and without OSA in either REM or non-REM sleep. Frequency-domain analysis during non-REM sleep in PAF patients with OSA showed increased cardiac parasympathetic modulation (HF-nu: 39.1 ± 15.7 vs 48.0 ± 14.6, p = 0.008) and reduced cardiac sympathetic modulation (LF-nu 54.1 ± 19.7 vs 43.7 ± 18.0, p = 0.012, LF/HF ratio: 2.1 ± 2.0 vs 1.2 ± 1.0, p = 0.007). Results remained significant after adjusting for age, sex, and BMI (adjusted p values 0.024, 0.045 and 0.018 respectively). There were no differences in HRV parameters during REM sleep. CONCLUSIONS: This is the first study of HRV in PAF patients with and without OSA. Our results indicate limited differences in HRV between groups. However, this work suggests a chronic increase in parasympathetic nervous modulation and relative reduction in sympathetic modulation in PAF patients with OSA during steady-state non-REM sleep. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10840-022-01202-3. Springer US 2022-04-09 2023 /pmc/articles/PMC10172286/ /pubmed/35397040 http://dx.doi.org/10.1007/s10840-022-01202-3 Text en © Crown 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Mohammadieh, Anna Mary
Dissanayake, Hasthi U.
Sutherland, Kate
Ucak, Seren
De Chazal, Philip
Cistulli, Peter A.
Does obstructive sleep apnoea modulate cardiac autonomic function in paroxysmal atrial fibrillation?
title Does obstructive sleep apnoea modulate cardiac autonomic function in paroxysmal atrial fibrillation?
title_full Does obstructive sleep apnoea modulate cardiac autonomic function in paroxysmal atrial fibrillation?
title_fullStr Does obstructive sleep apnoea modulate cardiac autonomic function in paroxysmal atrial fibrillation?
title_full_unstemmed Does obstructive sleep apnoea modulate cardiac autonomic function in paroxysmal atrial fibrillation?
title_short Does obstructive sleep apnoea modulate cardiac autonomic function in paroxysmal atrial fibrillation?
title_sort does obstructive sleep apnoea modulate cardiac autonomic function in paroxysmal atrial fibrillation?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172286/
https://www.ncbi.nlm.nih.gov/pubmed/35397040
http://dx.doi.org/10.1007/s10840-022-01202-3
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