title: Sleep-disordered breathing and daytime cardiac conduction abnormalities on 12-lead electrocardiogram in community-dwelling older men.
abstract: OBJECTIVE
  Nocturnal cardiac conduction abnormalities are commonly observed in patients with sleep-disordered breathing (SDB). However, few population-based studies have examined the association between SDB and daytime cardiac conduction abnormalities.
  
  
  METHODS
  We examined a random sample of 471 community-dwelling men, aged ≥67 years, enrolled in the multi-center Outcomes of Sleep Disorders in Older Men (MrOS Sleep) study. SDB severity was categorized using percent of total sleep time with oxygen saturation <90 % (%TST < 90) and apnea hypopnea index (AHI). Cardiac conduction parameters were assessed by resting 12-lead electrocardiography (ECG). All analyses were adjusted for age, site, β-blocker use, coronary heart disease, calcium channel blocker use, and use of antiarrhythmic medications.
  
  
  RESULTS
  Mean age was 77 ± 6 years, median %TST < 90 was 0.7 (IQR 0.00-3.40), and median AHI was 7.06 (IQR 2.55-15.32). Men with greater nocturnal hypoxemia (%TST < 90 ≥ 3.5 %) compared with those without hypoxemia (%TST < 90 < 1.0 %) had a lower odds of bradycardia (OR 0.55 [0.32-0.94]) and right bundle branch block (RBBB) (OR 0.24 [0.08-0.75]) but a higher odds of ventricular paced rhythm (OR 4.42 [1.29-15.19]). Heart rate (HR) increased in a graded manner with increasing %TST < 90 (p-trend 0.01) and increasing AHI (p-trend 0.006), but these gradients were small in absolute magnitude. There were no associations of SDB measures with other ECG conduction parameters.
  
  
  CONCLUSIONS
  Greater nocturnal hypoxemia in older men was associated with a lower prevalence of daytime sinus bradycardia and RBBB, a higher prevalence of ventricular paced rhythm, and higher resting HR.
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN, USA.|Department of Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA.
authors.forename: Younghoon
authors.initials: Y
authors.lastname: Kwon
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN, USA.|Department of Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Picel
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN, USA.|Department of Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Adabag
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Tien
authors.initials: T
authors.lastname: Vo
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN, USA.|Department of Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Taylor
authors.affiliation: Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.affiliation: Research Institute, California Pacific Medical Center, San Francisco, CA, USA.
authors.forename: Katie
authors.initials: K
authors.lastname: Stone
authors.affiliation: Department of Medicine, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Reena
authors.initials: R
authors.lastname: Mehra
authors.affiliation: Department of Psychiatry, University of California-San Diego, La Jolla, CA, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN, USA. ensru001@umn.edu.|Department of Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA. ensru001@umn.edu.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001919:Bradycardia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D000075224:Cardiac Conduction System Disease / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D013223:Statistics as Topic; D014481:United States
keywords: Electrocardiography; Pacemaker; Sleep-disordered breathing