Author + information
- Pınar Türker Bayır1,
- Burcu Demirkan2,
- Ömer Bayır3,
- Serkan Duyuler4,
- Hikmet Fırat5,
- Ümit Güray2 and
- Emel Cadallı Tatar3
Obstructive sleep apnea (OSA) is a common medical condition that is affecting approximately 5% to 15% of the population. Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. OSA has been shown to be associated with AF. Electrophysiological and electromechanical abnormalities resulting from intra and interatrial conduction disorders present a high risk as regards the generation of AF. Nasal continuous positive airway pressure (CPAP) is an effective and widely used method in the treatment of OSA. The purpose of the present study is to evaluate the short-term effects of nasal continuous positive airway pressure (CPAP) treatment on atrial electromechanical delay and p wave dispersion (Pd) in patients with obstructive sleep apnea (OSA).
A total of 24 OSA patients diagnosed with polysomnography who were planned to undergo CPAP therapy and 18 healthy subjects were included in the study. The basal intra and interatrial electromechanic delays prior to onset of the therapy were measured using Tissue Doppler Imaging (TDI). Pd was calculated on the basis of 12-lead ECG. In order to evaluate the effects of CPAP therapy, the patients underwent a re-evaluation on the basis of TDIs and 12-lead ECGs 6 months after the initiation of the therapy.
Interatrial, left intraatrial and right intraatrial electromechanical delays prior to the therapy were found to be significantly greater in OSA group compared with the therapy group (39.2±8 vs. 21.1±2.8, p<0,001; 20.5±7.2 vs. 11.1±2, p=0,003; 20.7±11 vs. 10±2.6, p<0,001, respectively). Pd was found to be increased in OSA group compared with the healthy controls (44±7 ms vs. 28.5±4 ms, p<0,001). Compared with the basal values, interatrial, left intraatrial and right intraatrial electromechanical delays measured with TDI during the re-evaluation 6 months after the CPAP therapy were found to decrease (39.2±8 vs. 28.7±6.5 p<0,001; 20.5±7.2 vs. 15.6 ±5.1, p<0,002; 20.7±11 vs. 13.1±7.3, p<0.001, respectively). Such decreases were also valid for the post-therapy Pd values, compared with the basal values (44±7 ms vs. 37±7, p<0.001).
CPAP therapy decreases the likelihood of AF generation by improving the electromechanical delay and P wave dispersion in patients with OSA.