Lazarus Arnaud, Varin Jean, Jauvert Gael, Alonso Christine, Duboc Denis
InParys Clinical Research Group, 12 rue Pasteur, 92210 Saint Cloud, France.
Neuromuscul Disord. 2007 May;17(5):392-9. doi: 10.1016/j.nmd.2007.01.014. Epub 2007 Mar 13.
The long-term relationship between cardiac arrhythmias and sleep apnoea in myotonic dystrophy (DM1) is unknown. Pacemakers enabling the long-term monitoring of electrocardiographic and ventilation parameters were implanted in 20 patients with DM1 (mean age = 42+/-11.6 years), followed 40+/-12.3 months. Arrhythmias were recorded by the pacemaker in 17 patients (85%): 14 developed arrhythmic episodes that occurred either in absence or in presence of concomitant sleep apnoea. Conversely, among these 14 patients, the majority of sleep apnoea episodes were not associated with concomitant arrhythmias. In the other three patients who developed arrhythmias, simultaneous sleep apnoea was never observed. Episodes of sleep apnoea were observed in all patients, though only 85% presented with sleep apnoea syndrome. In conclusion, a high incidence of arrhythmias and sleep apnoea was observed. While arrhythmias are generally attributable to an organic substrate, they are sometimes precipitated by functional triggers, as in the case of sleep apnoea.
强直性肌营养不良症（DM1）中心律失常与睡眠呼吸暂停之间的长期关系尚不清楚。对20例DM1患者（平均年龄 = 42±11.6岁）植入了能够长期监测心电图和通气参数的起搏器，并随访了40±12.3个月。起搏器记录到17例患者（85%）出现心律失常：14例出现了心律失常发作，这些发作在无或伴有睡眠呼吸暂停的情况下均可发生。相反，在这14例患者中，大多数睡眠呼吸暂停发作并未伴有心律失常。在另外3例出现心律失常的患者中，从未观察到同时存在的睡眠呼吸暂停。所有患者均观察到睡眠呼吸暂停发作，不过只有85%的患者表现为睡眠呼吸暂停综合征。总之，观察到心律失常和睡眠呼吸暂停的发生率很高。虽然心律失常通常归因于器质性病变，但有时也会由功能性触发因素诱发，如睡眠呼吸暂停的情况。
