Koehler U, Glaremin T, Cassel W, Feuring M, Pomykaj T, Schäfer H, Stellwaag M
Zentrum Innere Medizin, Medizinische Poliklinik, Philipps-Universität, Marburg.
Med Klin (Munich). 1993 Dec 15;88(12):684-90.
Patients with sleep apnea and nocturnal brady- and tachyarrhythmia are considered to be patients at especially high risk within the group of all apnea patients.
13 patients with sleep apnea (apnea-index > 10 events/h), suspected coronary heart disease and known increased frequency of nocturnal premature ventricular contractions (PVC) were studied. Polysomnography, long-term ECG and six-lead ECG were performed.
Within the period studied (1.00 to 6.00 o'clock), an average of 47 PVC per hour was recorded (range 4 to 337/h). In two patients 24 episodes of nocturnal myocardial ischemia were observed, but were not accompanied by PVC. Interestingly only 387 of 1371 premature ventricular contractions (28.2%) were associated to apnea/hyperventilation episodes. Arrhythmia occurred mainly during sleep stages I/II and REM (n.s.). There was a tendency towards more frequent PVC with more pronounced oxygen desaturations.
Patients with coronary heart disease, obstructive sleep apnea and severe hyoxemia are at higher risk of developing nocturnal PVC because reduced hypoxic tolerance of the heart may lead to electrical instability.
睡眠呼吸暂停以及夜间心动过缓和快速性心律失常患者被认为是所有呼吸暂停患者中风险特别高的群体。
对13例患有睡眠呼吸暂停（呼吸暂停指数>10次/小时）、疑似冠心病且已知夜间室性早搏（PVC）频率增加的患者进行了研究。进行了多导睡眠图、长期心电图和六导联心电图检查。
在研究期间（凌晨1点至6点），平均每小时记录到47次PVC（范围为4至337次/小时）。在两名患者中观察到24次夜间心肌缺血发作，但未伴有PVC。有趣的是，1371次室性早搏中只有387次（28.2%）与呼吸暂停/通气过度发作有关。心律失常主要发生在睡眠I/II期和快速眼动期（无显著差异）。氧饱和度下降越明显，PVC越频繁。
患有冠心病、阻塞性睡眠呼吸暂停和严重低氧血症的患者发生夜间PVC的风险更高，因为心脏对缺氧的耐受性降低可能导致电不稳定。
