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Simulated Obstructive Sleep Apnea Increases P-Wave Duration and P-Wave Dispersion
Thomas Gaisl1,2, Annette M Wons1, Valentina Rossi1
1Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
Plos One
|April 13, 2016
Summary
Simulating obstructive sleep apnea (OSA) maneuvers significantly increased P-wave duration and dispersion (Pd) in both healthy individuals and paroxysmal atrial fibrillation (PAF) patients. These findings suggest intrathoracic pressure changes may trigger PAF.
Area of Science:
- Cardiology
- Sleep Medicine
- Physiology
Background:
- High P-wave duration and dispersion (Pd) are linked to paroxysmal atrial fibrillation (PAF).
- Obstructive sleep apnea (OSA) is associated with PAF.
- The direct impact of OSA-simulating maneuvers on P-wave parameters is not fully understood.
Purpose of the Study:
- To investigate if short-term increases in P-wave duration and Pd can be induced by respiratory maneuvers simulating OSA.
- To compare these effects in healthy subjects and patients with PAF.
Main Methods:
- 12-lead electrocardiography (ECG) recorded in 24 healthy subjects and 33 PAF patients.
- Simulated obstructive apnea (Mueller maneuver, MM), obstructive hypopnea (inspiration through a threshold load, ITH), and central apnea (AP) were performed in randomized order.
- P-wave duration and Pd analyzed using dedicated ECG analysis software.
Main Results:
- P-wave duration and Pd significantly increased during MM and ITH compared to normal breathing (p<0.001).
- The increase in P-wave duration and Pd during MM was more pronounced in healthy subjects than in PAF patients (p<0.05).
Conclusions:
- Intrathoracic pressure swings during simulated OSA increase P-wave duration and Pd in both healthy individuals and PAF patients.
- These findings suggest that intrathoracic pressure changes may prolong intra-atrial and inter-atrial conduction times.
- This mechanism may represent an independent trigger for the development of PAF.
