Sleep-Disordered Breathing and Cardiac Arrhythmias in Adults: Mechanistic Insights and Clinical Implications: A Scientific Statement From the American Heart Association
Authors: Reena Mehra, MD, Mina K. Chung, MD, Brian Olshansky, MD, Dobromir Dobrev, MD, Chandra L. Jackson, PhD, Vaishnavi Kundel, MD, Dominik Linz, MD, Nancy S. Redeker, PhD, Susan Redline, MD, Prashanthan Sanders, MBBS, and Virend K. Somers, MD, on behalf of the American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology; and Stroke Council
Summary:
Review + synthesis of epidemiologic, experimental, and mechanistic data relating OSA (and other SDB) to arrhythmias.
Key Findings:
- Sleep disordered breathing (especially OSA) is linked to AF, ventricular tachyarrhythmias, bradyarrhythmias, and SCD
- Mechanisms include intermittent hypoxia, sympathetic/parasympathetic fluctuations, intrathoracic pressure
swings, and remodeling of atrial/ventricular structures.
swings, and remodeling of atrial/ventricular structures.
- CPAP treatment shown in observational/retrospective data to reduce arrhythmia burden (especially AF
recurrence) but randomized trial data still limited
recurrence) but randomized trial data still limited
