患有心房动的患者的阻塞性睡眠呼吸暂停:目前的知识和剩余的不确定性
Owen D Lyons1,2,3,4
1University of Toronto.
Current opinion in pulmonary medicine
|September 11, 2023
概括
阻塞性睡眠呼吸暂停 (OSA) 显著影响心房动,增加症状负担和复发风险. 持续正气道压力 (CPAP) 可以减轻这些风险,但需要进一步的研究.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 肺部病理学 肺部病理学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 在心房动 (AF) 患者中非常普遍.
- OSA有助于AF的发病,并与增加症状负担和住院病例有关.
- 未经治疗的OSA会增加AF复发的风险,在切除或心脏转换后.
研究的目的:
- 审查目前对OSA和AF之间的关系的理解.
- 要突出关于OSA查和AF患者治疗的新兴证据.
- 讨论OSA对AF管理的影响.
主要方法:
- 关于AF群体OSA查问卷的最近研究的综述.
- 分析关于OSA严重程度在一夜之间变化的发现.
- 对AF的CPAP治疗随机对照试验 (RCT) 证据的评估.
主要成果:
- 新的查问卷可能会改善AF患者的OSA识别.
- 在OSA严重程度的重大夜间变化影响了诊断测试.
- 虽然一些RCT显示没有益处,但有一项RCT表明CPAP可以减弱AF患者的心房基质.
结论:
- 需要进一步进行大规模的动力RCT.
- 精确定义的队列对于指导管理决策至关重要.
- 证据支持继续调查OSA查和CPAP治疗AF患者.
相关概念视频
Sleep Apnea
184
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
184
Dysrhythmias VI: Management of Dysrhythmias
19
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
19
Disturbances in Heart Rhythm
1.0K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
1.0K
Aortic Regurgitation III: Medical Management
24
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
24
Heart Failure VI: Adjunct Therapies
16
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
16
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
40
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
40


