title: Sleep apnea and ventricular arrhythmias: Clinical outcome, electrophysiologic characteristics, and follow-up after catheter ablation.
abstract: OBJECTIVE
  Sleep apnea is highly prevalent in patients with heart disease. However, the association between sleep apnea and ventricular arrhythmias is unclear. The aim of this study was to examine the relationship between sleep apnea and electrophysiologic characteristics and clinical outcome after catheter ablation in patients having ventricular arrhythmias.
  
  
  RESULTS
  Forty-four patients with ventricular tachycardia (VT) or premature ventricular complexes (PVCs) without structural heart diseases (57% men; mean age: 55 + or - 15 years) underwent a sleep study. Subjects with an apnea-hypopnea index (AHI) > or = 10/h were considered to have sleep apnea. Electrophysiologic studies were performed on all patients, and 35 patients underwent catheter ablation therapy. Seventeen patients (39%) had sleep apnea with an average AHI of 27 + or - 17/h. Electrophysiologic characteristics of ventricular arrhythmias showed that sites of VT/PVCs origin in the pulmonary artery and the aortic sinus of Valsalva were detected in 27% and 20% patients with sleep apnea, which was a relatively higher rate than that in patients without sleep apnea (8% and 0%, respectively). Successful catheter ablation was achieved in 11 patients (85%) with sleep apnea and 17 (77%) without sleep apnea. During a mean follow-up period of 13.5 + or - 7.3 months after catheter ablation, 5 patients (45%) with sleep apnea and 1 patient (6%) without sleep apnea experienced recurrent VT/PVCs. Comparing the outcome between the two groups, the VT/PVCs recurrence rate was significantly higher in patients with sleep apnea than in those without sleep apnea (p=0.02).
  
  
  CONCLUSIONS
  Ventricular arrhythmia patients with sleep apnea have a high recurrence of arrhythmias after successful catheter ablation. Patients with ventricular arrhythmias should be systematically assessed for sleep apnea owing to the potential detrimental effects of sleep apnea in the follow-up period.
authors.affiliation: Department of Cardiology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan. y-koshino@umin.ac.jp
authors.forename: Yuki
authors.initials: Y
authors.lastname: Koshino
authors.forename: Makoto
authors.initials: M
authors.lastname: Satoh
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Katayose
authors.forename: Kenji
authors.initials: K
authors.lastname: Kuroki
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sekiguchi
authors.forename: Hiro
authors.initials: H
authors.lastname: Yamasaki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshida
authors.forename: Kyo
authors.initials: K
authors.lastname: Yasuda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tanigawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kuga
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Aonuma
mesh_terms: D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012891:Sleep Apnea Syndromes / Q000150:complications*; D017180:Tachycardia, Ventricular / Q000150:complications / Q000601:surgery; D018754:Ventricular Dysfunction / Q000145:classification* / Q000503:physiopathology / Q000601:surgery