ObjectivesTo assess the prevalence and types of arrhythmias in Saudi OSA patients and
to identify predictors of arrhythmia in this group of patients.MethodsThis case-control study included all patients who underwent level I attended
overnight polysomnography between 2009 and 2012. Electrocardiographic data
collected during sleep studies of patients with and without OSA were
manually reviewed.ResultsThe study comprised 498 patients (394 OSA patients and 104 non-OSA patients
(controls). The prevalence of arrhythmia in OSA patients was higher than
that in the controls (26.9% vs. 11.5%; p=0.001). Comparing OSA patients and
controls showed: premature atrial contraction (10.2%vs.2.9%;p=0.019),
premature ventricular contraction (PVC) (19.3%vs.9.6%;p=0.02), non-isolated
PVC (bi/tri/qua) 10.8%vs.2.3%;p=0.04) and atrial fibrillation
(1.6%vs.0%;p=0.001). Multiple logistic regression analysis revealed that,
patients with OSA had twice the odds of having any cardiac arrhythmia (OR
1.91; CI 95% 1.27-3.11; p <0.05).ConclusionsPatients with OSA had a higher prevalence of arrhythmia compared to controls,
and OSA is a predictor of arrhythmia during sleep.
Proper interpretation of the spectral Doppler signal and elucidation of the underlying hemodynamics can at times be problematic due to confounding factors, one of them being a rapid heart rate. In this article, we discuss the use of carotid sinus massage (CSM) in the echocardiography laboratory as a maneuver to reduce the resting heart rate and thus render the transmitral Doppler signal more amenable to analysis. We provide examples of the value of the CSM in the assessment of left ventricular filling pressure.
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