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Electrocardiographic changes in obstructive sleep apnoea syndrome

M M Khalil1, O A Rifaie

  • 1Chest Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Respiratory Medicine
|March 31, 1998
PubMed
Summary

Obstructive sleep apnoea syndrome (OSAS) significantly impacts the heart, causing distinct electrocardiographic (ECG) changes. These ECG patterns are associated with disease severity and can aid in diagnosing OSAS.

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Area of Science:

  • Cardiology
  • Sleep Medicine
  • Medical Diagnostics

Background:

  • Obstructive sleep apnoea syndrome (OSAS) exerts both acute and chronic detrimental effects on the cardiovascular system, affecting both right and left heart structures.
  • Electrocardiographic (ECG) abnormalities are frequently observed in patients with OSAS, reflecting cardiac involvement.

Purpose of the Study:

  • To investigate the prevalence and characteristics of electrocardiographic patterns in patients diagnosed with obstructive sleep apnoea syndrome.
  • To determine the association between specific ECG findings and the severity of OSAS, as indicated by polysomnographic data and daytime oxygen levels.

Main Methods:

  • Electrocardiographic (ECG) patterns were analyzed in a cohort of 190 patients with diagnosed obstructive sleep apnoea syndrome.
  • Statistical analysis was performed to compare polysomnographic data and daytime PaO2 levels between OSAS patients with and without specific ECG findings.

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Main Results:

  • Common ECG findings included persistent deep S waves in lateral chest leads (V5, V6), left anterior hemiblock, and RS patterns with deep S waves in inferior and lateral leads.
  • Specific prevalent patterns involved left axis deviation combined with deep S waves in various leads (e.g., I, aVf, V6).
  • OSAS patients exhibiting ECG abnormalities showed statistically significant differences in polysomnographic data and daytime PaO2 compared to those without ECG findings, with the latter group displaying milder disease evidence.

Conclusions:

  • The study suggests a high prevalence of ECG abnormalities in OSAS patients, potentially related to late depolarization of the hypertrophied right outflow tract and/or left anterior fascicular block.
  • An evolving, peculiar ECG pattern associated with OSAS progression was identified, which may assist in diagnosing the condition when other cardiac diseases are ruled out.