Obstructive sleep apnoea and nocturnal atrial fibrillation in patients with ischaemic heart disease
Introduction: Arrhythmias, especially atrial fibrillation (AF) and ventricular arrhythmias, are independent risk factors of mortality in patients with ischaemic heart disease (IHD). While there is a growing body of evidence that suggests an association between obstructive sleep apnoea (OSA) and card...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer – Medknow Publications
2025-04-01
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| Series: | Singapore Medical Journal |
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| Online Access: | https://journals.lww.com/10.4103/singaporemedj.SMJ-2021-293 |
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| author | Silin Kuang Yiong Huak Chan Serene Wong See Meng Khoo |
| author_facet | Silin Kuang Yiong Huak Chan Serene Wong See Meng Khoo |
| author_sort | Silin Kuang |
| collection | DOAJ |
| description | Introduction:
Arrhythmias, especially atrial fibrillation (AF) and ventricular arrhythmias, are independent risk factors of mortality in patients with ischaemic heart disease (IHD). While there is a growing body of evidence that suggests an association between obstructive sleep apnoea (OSA) and cardiac arrhythmias, evidence on this relationship in patients with IHD has been scant and inconsistent. We hypothesised that in patients with IHD, severe OSA is associated with an increased risk of nocturnal arrhythmias.
Methods:
We studied 103 consecutive patients with IHD who underwent an overnight polysomnography. Exposed subjects were defined as patients who had an apnoea–hypopnoea index (AHI) ≥30/h (severe OSA), and nonexposed subjects were defined as patients who had an AHI <30/h (nonsevere OSA). All electrocardiograms (ECGs) were interpreted by the Somte ECG analysis software and confirmed by a physician blinded to the presence or absence of exposure. Arrhythmias were categorised as supraventricular and ventricular. Arrhythmia subtypes (ventricular, atrial and conduction delay) were analysed as dichotomous outcomes using multiple logistic regression models.
Results:
Atrial fibrillation and AF/flutter (odds ratio 13.5, 95% confidence interval 1.66–109.83; P = 0.003) were found to be more common in the severe OSA group than in the nonsevere OSA group. This association remained significant after adjustment for potential confounders. There was no significant difference in the prevalence of ventricular and conduction delay arrhythmias between the two groups.
Conclusion:
In patients with IHD, there was a significant association between severe OSA and nocturnal AF/flutter. This underscores the need to evaluate for OSA in patients with IHD, as it may have important implications on clinical outcomes. |
| format | Article |
| id | doaj-art-1c31a44ec80047559bd2c7dda0ee3fb6 |
| institution | DOAJ |
| issn | 0037-5675 2737-5935 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wolters Kluwer – Medknow Publications |
| record_format | Article |
| series | Singapore Medical Journal |
| spelling | doaj-art-1c31a44ec80047559bd2c7dda0ee3fb62025-08-20T02:56:15ZengWolters Kluwer – Medknow PublicationsSingapore Medical Journal0037-56752737-59352025-04-0166419019410.4103/singaporemedj.SMJ-2021-293Obstructive sleep apnoea and nocturnal atrial fibrillation in patients with ischaemic heart diseaseSilin KuangYiong Huak ChanSerene WongSee Meng KhooIntroduction: Arrhythmias, especially atrial fibrillation (AF) and ventricular arrhythmias, are independent risk factors of mortality in patients with ischaemic heart disease (IHD). While there is a growing body of evidence that suggests an association between obstructive sleep apnoea (OSA) and cardiac arrhythmias, evidence on this relationship in patients with IHD has been scant and inconsistent. We hypothesised that in patients with IHD, severe OSA is associated with an increased risk of nocturnal arrhythmias. Methods: We studied 103 consecutive patients with IHD who underwent an overnight polysomnography. Exposed subjects were defined as patients who had an apnoea–hypopnoea index (AHI) ≥30/h (severe OSA), and nonexposed subjects were defined as patients who had an AHI <30/h (nonsevere OSA). All electrocardiograms (ECGs) were interpreted by the Somte ECG analysis software and confirmed by a physician blinded to the presence or absence of exposure. Arrhythmias were categorised as supraventricular and ventricular. Arrhythmia subtypes (ventricular, atrial and conduction delay) were analysed as dichotomous outcomes using multiple logistic regression models. Results: Atrial fibrillation and AF/flutter (odds ratio 13.5, 95% confidence interval 1.66–109.83; P = 0.003) were found to be more common in the severe OSA group than in the nonsevere OSA group. This association remained significant after adjustment for potential confounders. There was no significant difference in the prevalence of ventricular and conduction delay arrhythmias between the two groups. Conclusion: In patients with IHD, there was a significant association between severe OSA and nocturnal AF/flutter. This underscores the need to evaluate for OSA in patients with IHD, as it may have important implications on clinical outcomes.https://journals.lww.com/10.4103/singaporemedj.SMJ-2021-293atrial fibrillationcardiac arrhythmiasischaemic heart diseaseobstructive sleep apnoea |
| spellingShingle | Silin Kuang Yiong Huak Chan Serene Wong See Meng Khoo Obstructive sleep apnoea and nocturnal atrial fibrillation in patients with ischaemic heart disease Singapore Medical Journal atrial fibrillation cardiac arrhythmias ischaemic heart disease obstructive sleep apnoea |
| title | Obstructive sleep apnoea and nocturnal atrial fibrillation in patients with ischaemic heart disease |
| title_full | Obstructive sleep apnoea and nocturnal atrial fibrillation in patients with ischaemic heart disease |
| title_fullStr | Obstructive sleep apnoea and nocturnal atrial fibrillation in patients with ischaemic heart disease |
| title_full_unstemmed | Obstructive sleep apnoea and nocturnal atrial fibrillation in patients with ischaemic heart disease |
| title_short | Obstructive sleep apnoea and nocturnal atrial fibrillation in patients with ischaemic heart disease |
| title_sort | obstructive sleep apnoea and nocturnal atrial fibrillation in patients with ischaemic heart disease |
| topic | atrial fibrillation cardiac arrhythmias ischaemic heart disease obstructive sleep apnoea |
| url | https://journals.lww.com/10.4103/singaporemedj.SMJ-2021-293 |
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