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Updated: Jun 22, 2026
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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Advanced atrioventricular block induced by obstructive sleep apnea before oxygen desaturation
Ken-ichi Maeno1, Atsunobu Kasai, Morimichi Setsuda
1Division of Cardiology, Yamada Red Cross Hospital, Mie, Japan. maeken@zk9.so-net.ne.jp
Heart and Vessels
|May 26, 2009
Summary
Obstructive sleep apnea (OSA) can cause temporary advanced atrioventricular (AV) block, even before oxygen levels drop. Continuous positive airway pressure (CPAP) therapy effectively resolved this bradyarrhythmia in a patient.
Area of Science:
- Cardiology
- Sleep Medicine
- Electrophysiology
Background:
- Obstructive sleep apnea (OSA) is a common condition associated with cardiovascular complications.
- Atrioventricular (AV) block is a cardiac conduction abnormality that can lead to bradycardia.
- The link between OSA and AV block, particularly before oxygen desaturation, requires further investigation.
Observation:
- A 54-year-old male presented with severe OSA diagnosed via polysomnography.
- During sleep, the patient experienced advanced AV block with prolonged ventricular asystole (>6 seconds).
- This event occurred at the onset of OSA, preceding any significant oxygen desaturation.
Findings:
- Electrophysiological studies confirmed normal intrinsic AV nodal and His-Purkinje system function.
- The advanced AV block was transient and directly correlated with OSA events.
- Continuous positive airway pressure (CPAP) therapy led to the complete resolution of the AV block.
Implications:
- OSA can induce significant bradyarrhythmias, including advanced AV block, independent of hypoxemia.
- Early identification and treatment of OSA may prevent severe cardiac events like asystole.
- This case highlights the importance of considering sleep-disordered breathing in patients with unexplained conduction abnormalities.
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