title: Treatment of tachycardia: bradycardia syndrome in a patient with obstructive sleep apnoea.
abstract: Obstructive sleep apnoea (OSAS) affects 4% of men and 2% of women aged 30-65 years. It is diagnosed in the presence of excessive daytime sleepiness and an apnoea-hypopnoea index (AHI) of ≥5 on polysomnography. Rhythm disturbances are common in OSAS and continuous positive airway pressure (CPAP) has been shown to be beneficial. We present a case of a patient with obesity, atrial fibrillation with fast ventricular response, significant nocturnal pauses (3.9 s) and tachycardiomyopathy. A polysomnography confirmed severe OSAS (AHI=64.25). CPAP improved bradycardia and allowed for the introduction of β-blockers. Subsequent Holter monitoring revealed better rate control with the longest pause of 2 s and the patient's left ventricular systolic function improved. CPAP prevented our patient from invasive treatment, allowed for rate control and improvement of tachycardiomyopathy. With such a high prevalence of OSAS, clinicians should be aware that CPAP may aid arrhythmia control.
authors.affiliation: Department of Cardiology, Arrowe Park Hospital, Liverpool, UK.
authors.forename: Jakub
authors.initials: J
authors.lastname: Lagan
authors.affiliation: Department of Cardiology, Arrowe Park Hospital, Liverpool, UK.
authors.forename: Palaniappan
authors.initials: P
authors.lastname: Saravanan
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001919:Bradycardia / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D045422:Continuous Positive Airway Pressure; D004232:Diuretics / Q000008:administration & dosage*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D013610:Tachycardia / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics
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