[Value of Holter ECG in the diagnosis of sleep apnea syndrome in patients with massive obesity].
OBJECTIVE
Assess the diagnostic contribution of cyclic nocturnal variations in heart rate in sleep apnea syndrome.


METHODS
Holter recordings performed in a population of 30 patients with massive obesity defined as a body mass index greater than 40 kg/m2 and sleep apnea syndrome defined by an apnea index greater than 5 apneas per hour were analyzed retrospectively. The control group was composed of 15 patients with massive obesity but without sleep apnea syndrome. High variability in nocturnal heart rate was assessed using a visual criterion defined as repeated episodes of progressive reduction in heart rate followed by a sudden acceleration reaching a difference of 30 bpm between the highest and lowest heart rate and occurring at least 5 times during one consecutive hour of recording.


RESULTS
Increased nocturnal variability in heart rate was evidenced in all the patients with sleep apnea syndrome (30/30) but was not observed in any of the control subjects (0/15).


CONCLUSIONS
These results suggest that Holter recordings can be a useful tool for the diagnosis of sleep apnea syndrome.
Pascal-Sébaoun
S
S
Service de Pneumologie et de Réanimation, Hôtel Dieu, Paris.
Milosevic
D
D
Orvoën-Frija
E
E
Léger
D
D
Basdevant
A
A
Laaban
J P
JP
D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000150:complications*; D012189:Retrospective Studies; D012744:Sex Ratio; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000209:etiology