肺静脉隔离对心房颤动患者阻塞性睡眠呼吸暂停的影响。
Impact of pulmonary vein isolation on obstructive sleep apnea in patients with atrial fibrillation.
作者信息
Hoyer Friedrich Felix, Henrich Katharina, Kreuz Jens, Pizarro Carmen, Schrickel Jan-Wilko, Lickfett Lars Martin, Mittmann-Braun Erica, Juergens Uwe, Nickenig Georg, Skowasch Dirk
机构信息
Department of Internal Medicine II, Cardiology, Pneumology, University of Bonn, Germany.
出版信息
Cardiol J. 2014;21(4):392-6. doi: 10.5603/CJ.a2013.0122. Epub 2013 Aug 30.
BACKGROUND
Obstructive sleep apnea (OSA) has been identified as associated with the onset and propagation of atrial fibrillation (AF) and predicts recurrences of AF after pulmonary vein isolation (PVI). Vice versa, it has never been investigated whether PVI influences OSA. However, it has been controversial whether a restored atrial function can affect the course of OSA. There-fore, we have assessed whether PVI procedure modulates the prevalence and severity of OSA.
METHODS AND RESULTS
We included 23 individuals with AF that were assigned to undergo PVI into this study. Patients were 65 ± 7 years old, obese (BMI 29.9 ± 5.4 kg/m²), white (100%) and had a normal left ventricular function (LVEF 64 ± 9%). Polygraphic assessment was carried out before and 6 months after PVI. The prevalence of OSA, defined as an apnea-hypopnea index (AHI) ≥ 5 per hour of sleep, was 74% before PVI compared to 70% 6 months after the procedure (p > 0.05). Severity of OSA did not differ (AHI before vs. after: 18 ± 18/h vs. 15 ± 17/h, p > 0.05) as well as further polygraphic parameters did not differ before and after the procedure.
CONCLUSIONS
Prevalence and severity of OSA are not affected by PVI in patients suffering from AF.
背景
阻塞性睡眠呼吸暂停（OSA）已被确定与心房颤动（AF）的发生和发展相关，并可预测肺静脉隔离（PVI）后AF的复发。反之，PVI是否会影响OSA尚未得到研究。然而，心房功能恢复是否会影响OSA的病程一直存在争议。因此，我们评估了PVI手术是否会调节OSA的患病率和严重程度。
方法和结果
我们纳入了23例计划接受PVI的AF患者进行本研究。患者年龄为65±7岁，肥胖（BMI 29.9±5.4kg/m²），均为白人（100%），左心室功能正常（左心室射血分数[LVEF] 64±9%）。在PVI术前和术后6个月进行多导睡眠图评估。定义为每小时睡眠呼吸暂停低通气指数（AHI）≥5的OSA患病率，PVI术前为74%，术后6个月为70%（p>0.05）。OSA的严重程度无差异（术前与术后AHI：18±18/小时 vs. 15±17/小时，p>0.05），且术后多导睡眠图的其他参数也无差异。
结论
AF患者的OSA患病率和严重程度不受PVI的影响。
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