[New approaches to treatment of bradyarrhythmia in patients with obstructive sleep apnea syndrome].
OBJECTIVE
To confirm or reject effects of CPAP on sleep asystole and to elucidate possible dependence on correction of respiratory disorders.


METHODS
Thirteen patients (11 males and 2 females aged 19 to 66 years) with bradyarrhythmia (BA) arising in sleep participated in the study. BA was caused by transient atrioventricular block of the degree II-III in 9 cases (69%), episodes of sinus node arrest and/or synoatrial block in 6 (46%) cases. Two (15%) patients had combination of BA forms. To diagnose sleep respiratory disorders, polysomnography (PSG) was made. Diagnostic criteria of sleep obstructive apnea syndrome (SOAS) were apnea/hypopnea index (AHI) more than 5 episodes for 1 hour sleep. The patients were divided into two groups. Individual selection of therapeutic pressure under PSG control was performed in SOAS patients (the study group). CPAP-therapy was effective in AHI < 5. In the control group (AHI < 5) such selection was made too. CPAP-therapy was effective in the controls if episodes of apnea/hypopnea were not registered through the night of monitoring.


RESULTS
In the study group CPAP-therapy was effective. The AHI decreased from 73.2 to 4.4, oxygen saturation of arterial blood increased from 74 to 85%, mean duration of asystoles fell from 5.2 to 1.3 s, pauses with duration more than 2 s disappeared. In the control group sleep apnea/hypopnea episodes disappeared but in asystole CPAP was uneffective.


CONCLUSIONS
CPAP-therapy is effective and pathogenetically sound method of treating patients with nocturnal bradyarrhythmia associated with sleep respiratory disorders.
Litvin
A Iu
AIu
Pevzner
A V
AV
Golitsyn
P V
PV
Galiavi
R A
RA
Mazygula
E P
EP
Nesterenko
L Iu
LIu
Chazova
I E
IE
Golitsyn
S P
SP
D000328:Adult; D000368:Aged; D001919:Bradycardia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome