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Impact of Continuous Positive Airway Pressure Therapy on Atrial Electromechanical Delay in Obesity‐Hypoventilation Syndrome Patients
Author(s) -
RUSSO VINCENZO,
MEO FEDERICA,
RAGO ANNA,
MOSELLA MARCO,
MOLINO ANTONIO,
RUSSO MARIA GIOVANNA,
NIGRO GERARDO
Publication year - 2016
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12879
Subject(s) - medicine , obesity hypoventilation syndrome , cardiology , anesthesia , reentry , hypercapnia , atrial fibrillation , continuous positive airway pressure , hypoventilation , hypoxemia , population , obstructive sleep apnea , respiratory system , environmental health
Impact of Continuous Positive Airway Pressure Background Obesity‐hypoventilation syndrome (OHS) is defined as daytime hypercapnia and hypoxemia in obese patients with sleep‐disordered breathing. We evaluated the electrocardiographic P‐wave duration and dispersion (PD) and echocardiographic noninvasive indicators of atrial conduction heterogeneity in OHS patients and the impact of CPAP on atrial conduction and atrial fibrillation incidence. Methods and Results We enrolled 50 OHS patients and 50 sex‐ and age‐matched obese subjects as control. Study population underwent cardiologic evaluation and polysomnography before enrollment, at 1‐ and 6‐month follow‐ups after CPAP therapy. The OHS group showed a significant increase in inter‐atrial (35.2 ± 8 milliseconds vs. 20.1 ± 2.7 milliseconds, P < 0.0001), intra‐left (30.5 ± 7.2 milliseconds vs. 16.5 ± 2 milliseconds, P < 0.0001), and intra‐right atrial electromechanical delays (AEMD)(24.8 ± 10 milliseconds vs. 15 ± 2.6 milliseconds, P < 0.0001) as well as in Pmax (130 ± 7.4 milliseconds vs. 97 ± 7.2 milliseconds, P = 0.002) and PD (56.5 ± 8.5 milliseconds vs. 31 ± 7.2 milliseconds, P = 0.002) compared to the control group. Significant improvement was noted after 6 months of CPAP therapy in inter‐atrial (35.2 ± 8 milliseconds vs. 24.5 ± 6.3 milliseconds, P < 0.0001), intra‐left (30.5 ± 7.2 milliseconds vs. 20.6 ± 5 milliseconds, P = 0.003), and intra‐right AEMD (24.8 ± 10 milliseconds vs. 17 ± 7.5 milliseconds, P < 0.0001), as well as in Pmax (130 ± 7.4 milliseconds vs. 95 ± 10 milliseconds, P < 0.0001) and in PD (56.5 ± 8.5 milliseconds vs. 32.5 ± 6 milliseconds, P < 0.0001) in the OHS group. External loop recorder monitoring detected paroxysmal AF in 19 OHS patients (38%) with significant reduction in paroxysmal AF episodes (12 ± 6 vs. 47 ± 12, P < 0.0001) after 6‐month CPAP therapy. Conclusion Our findings showed a significant increase of electrocardiographic and echocardiographic indexes of atrial conduction heterogeneity in OHS patients. The CPAP therapy, having a positive impact on atrial conduction time, seems to reduce AF incidence in OHS patients