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Sleep-disordered breathing is associated with disturbed cardiac repolarization in patients with a coronary artery

Christina Schmidleitner1, Michael Arzt1, Maria Tafelmeier1

  • 1Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany.

Sleep Medicine
|February 21, 2018
PubMed

Insights

Sleep-disordered breathing (SDB) is linked to abnormal cardiac repolarization before coronary artery bypass graft surgery (CABG). This suggests SDB may increase the risk of ventricular arrhythmias after CABG.

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Cardiac Electrophysiology

Background:

  • Malignant ventricular arrhythmias post-coronary artery bypass graft surgery (CABG) are linked to abnormal cardiac repolarization.
  • Sleep-disordered breathing (SDB) is associated with prolonged cardiac repolarization in non-surgical patients.

Purpose of the Study:

  • To evaluate cardiac repolarization in CABG patients with and without SDB.
  • To determine if SDB is an independent risk factor for abnormal cardiac repolarization before CABG.

Main Methods:

  • Retrospective evaluation of 100 CABG patients.
  • Polygraphy to diagnose SDB (apnea-hypopnea index ≥15/h), differentiating central (CSA) and obstructive (OSA).
  • Assessment of cardiac repolarization using T-peak-to-end (TpTe) and QTc intervals, and TpTe/QT ratios from 12-lead ECG.

Main Results:

  • 37% of patients had SDB (14% CSA, 23% OSA).
  • Patients with CSA and OSA exhibited significantly longer TpTe intervals and altered QTc intervals and TpTe/QT ratios compared to those without SDB.
  • SDB was independently associated with abnormal cardiac repolarization, irrespective of risk factors like age, BMI, or heart failure.

Conclusions:

  • Sleep-disordered breathing is significantly associated with abnormal cardiac repolarization prior to CABG.
  • SDB may be a contributing factor to the increased risk of ventricular arrhythmias following CABG.
Abstract

Keywords:
Cardiac arrhythmiasCardiac repolarizationCoronary artery bypass graft surgeryQTSleep apneaTpTe

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