Impact of Sleep-Disordered Breathing on Life-Threatening Ventricular Arrhythmia in Heart Failure Patients With Implantable Cardioverter-Defibrillator
Impact of Sleep-Disordered Breathing on Life-Threatening Ventricular Arrhythmia in Heart Failure Patients With Implantable Cardioverter-Defibrillator
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DOI：
10.1016/j.amjcard.2008.05.057
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发表时间：
2008-10-15
影响因子：
2.8
通讯作者：
Hagiwara, Nobuhisa
中科院分区：
文献类型：
--
作者：
Serizawa, Naoki;Yurnino, Dai;Hagiwara, Nobuhisa
睡眠呼吸障碍(SDB)与心律失常和心脏性猝死有关。然而，目前尚不清楚SDB的存在是否增加了植入心脏复律除颤器(ICD)的心力衰竭(HF)患者发生危及生命的室性心律失常的风险。对71名患有心力衰竭和ICD的患者进行前瞻性研究，他们在睡眠研究后进行了180天的随访。在睡眠研究中，所有患者的射血分数=10次/小时。比较有无SDB患者的ICD治疗频率和ICD治疗的昼夜模式。71例患者中有47例(66%)诊断为SDB。有无SDB患者的基础心功能差异无统计学意义。然而，有SDB的患者(43%)比没有SDB的患者(17%；p=0.029)更容易接受适当的ICD治疗。在多变量分析中，SDB的存在是合适的ICD治疗的独立预测因素(风险比4.0595%可信区间1.2013.65，p=0.015)。此外，有SDB的患者从午夜到早上6点的总ICD治疗率(34%)显著高于无SDB的患者(13%；p=0.046)。总之，在伴有ICD的心衰患者中，SDB的存在是常见的，并且是更有可能发生在睡眠中的危及生命的室性心律失常的独立预测因素。(C)2008 Elsevier Inc.保留所有权利。(美国心脏杂志2008；102：1064-1068)
It was recognized that sleep-disordered breathing (SDB) is associated with cardiac arrhythmia and sudden cardiac death. However, it was unclear whether the presence of SDB increased the risk of life-threatening ventricular arrhythmia in patients with heart failure (HF) with an implantable cardioverter-defibrillator (ICD). Seventy-one patients with HF and an ICD who were followed up for 180, days after a sleep study were prospectively studied. All patients had an ejection fraction = 10 events/hour on the sleep study. The frequency of appropriate ICD therapy and the day-night pattern of ICD therapies were compared between patients with and without SDB. SDB was diagnosed in 47 of 71 patients (66%). There were no statistical differences between patients with and without SDB in baseline cardiac function. However, appropriate ICD therapies occurred more frequently in patients with (43%) than without SDB (17%; p = 0.029). On multivariate analysis, the presence of SDB was an independent predictor for appropriate ICD therapy (hazard ratio 4.05, 95% confidence interval 1.20 to 13.65, p = 0.015). Moreover, the rate of total ICD therapy from midnight to 6 A.M. was significantly higher in patients with (34%) than without SDB (13%; p = 0.046). In conclusion, in patients with HF with an ICD, the presence of SDB was common and an independent predictor of life-threatening ventricular arrhythmias that were more likely to occur during sleep. (C) 2008 Elsevier Inc. All rights reserved. (Am J Cardiol 2008;102: 1064-1068)