From sleep apnea to arrhythmia: p-wave parameters as non-invasive predictors

Area of Science:

• Cardiology
• Sleep Medicine
• Electrophysiology

Background:

• Obstructive sleep apnea hypopnea syndrome (OSAHS) is associated with increased atrial fibrillation (AF) risk.
• This study investigates complex atrial arrhythmias as an advanced endpoint in OSAHS.
• Non-invasive P-wave parameters (PWPs) are explored for early identification of these arrhythmias.

Purpose of the Study:

• To identify non-invasive predictors of complex atrial arrhythmias in patients with OSAHS.
• To evaluate the predictive value of P-wave parameters for complex atrial arrhythmias.
• To enable early identification and risk stratification of OSAHS patients.

Main Methods:

• Retrospective analysis of 1,000+ patients with sleep disorders.
• Categorization into control, mild, moderate, and severe OSAHS groups based on AHI.
• Analysis of clinical characteristics, PWPs, atrial arrhythmias, and echocardiographic findings using statistical methods including logistic regression and ROC curves.

Main Results:

• Severe OSAHS patients showed prolonged P-wave duration and elevated Macruz Index.
• P terminal force in lead V1 (PtfV1) was higher in moderate and severe OSAHS groups.
• PtfV1 and Macruz Index were identified as independent predictors of complex atrial arrhythmias with moderate predictive value (AUCs 0.701 and 0.681).

Conclusions:

• P-wave parameters, particularly PtfV1 and the Macruz Index, serve as valuable non-invasive predictors.
• These parameters can aid in assessing atrial arrhythmia risk in OSAHS patients.
• Early identification of complex atrial arrhythmias is achievable through PWP analysis in OSAHS.