TY - JOUR
T1 - Sleep-disordered breathing in patients with the Brugada syndrome
AU - MacEdo, Paula G.
AU - Brugada, Josep
AU - Leinveber, Pavel
AU - Benito, Begoña
AU - Molina, Irma
AU - Sert-Kuniyoshi, Fatima
AU - Adachi, Taro
AU - Bukartyk, Jan
AU - Van Der Walt, Christelle
AU - Konecny, Tomas
AU - Maharaj, Shantal
AU - Kara, Tomas
AU - Montserrat, Josep
AU - Somers, Virend
N1 - Funding Information:
Dr. Somers is supported by Grants HL65176 and 1 UL1 RR 024150 from the National Institutes of Health , Bethesda, Maryland. Mr. Leinveber, Mr. Bukartyk, Dr. Konecny, and Dr. Kara were partially supported from Grants NS10099-3/20008 , NS10098-3/2008 , and NT11401-5/2011 from the Czech Ministry of Health .
PY - 2011/3/1
Y1 - 2011/3/1
N2 - We investigated breathing patterns and the occurrence of arrhythmias and ST-segment changes during sleep in patients with Brugada syndrome. Patients with Brugada syndrome are more likely to die from ventricular arrhythmias during sleep. ST-segment changes have been correlated with risk of sudden cardiac death. Whether sleep disturbances may contribute to arrhythmogenesis is unknown. Patients with Brugada syndrome underwent overnight polysomnography with simultaneous 12-lead electrocardiographic recording. A control group matched by age, gender, and body mass index (BMI) also underwent polysomnography. Twenty patients were included (50 ± 15 years old, 75% men). Despite their normal BMI (24.7 ± 2.7 kg/m2), 45% had sleep-disordered breathing (SDB), with a mean apnea-hypopnea index of 17.2 ± 14 events/hour. In patients with a high risk of arrhythmias, 5 (63%) had SDB. In the control group, 27% had SDB. Atrial or ventricular arrhythmias were not observed. Spontaneous ST-segment changes occurred in 2 patients over 45 different time points. Most ST-segment changes were observed during rapid eye movement sleep (31%) or within 1 minute of arousals (44%). Regarding respiratory events, 25 (56%) of ST-segment changes were related to occurrence of apnea or hypopnea. In conclusion, patients with Brugada syndrome have a high prevalence of SDB even in the setting of normal BMI. The higher incidence of nocturnal death in patients with Brugada syndrome may be conceivably related to co-morbid SDB. Moreover, autonomic instability encountered in rapid eye movement sleep and arousals could potentiate the risk of arrhythmias.
AB - We investigated breathing patterns and the occurrence of arrhythmias and ST-segment changes during sleep in patients with Brugada syndrome. Patients with Brugada syndrome are more likely to die from ventricular arrhythmias during sleep. ST-segment changes have been correlated with risk of sudden cardiac death. Whether sleep disturbances may contribute to arrhythmogenesis is unknown. Patients with Brugada syndrome underwent overnight polysomnography with simultaneous 12-lead electrocardiographic recording. A control group matched by age, gender, and body mass index (BMI) also underwent polysomnography. Twenty patients were included (50 ± 15 years old, 75% men). Despite their normal BMI (24.7 ± 2.7 kg/m2), 45% had sleep-disordered breathing (SDB), with a mean apnea-hypopnea index of 17.2 ± 14 events/hour. In patients with a high risk of arrhythmias, 5 (63%) had SDB. In the control group, 27% had SDB. Atrial or ventricular arrhythmias were not observed. Spontaneous ST-segment changes occurred in 2 patients over 45 different time points. Most ST-segment changes were observed during rapid eye movement sleep (31%) or within 1 minute of arousals (44%). Regarding respiratory events, 25 (56%) of ST-segment changes were related to occurrence of apnea or hypopnea. In conclusion, patients with Brugada syndrome have a high prevalence of SDB even in the setting of normal BMI. The higher incidence of nocturnal death in patients with Brugada syndrome may be conceivably related to co-morbid SDB. Moreover, autonomic instability encountered in rapid eye movement sleep and arousals could potentiate the risk of arrhythmias.
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U2 - 10.1016/j.amjcard.2010.10.046
DO - 10.1016/j.amjcard.2010.10.046
M3 - Article
C2 - 21247540
AN - SCOPUS:79951577304
SN - 0002-9149
VL - 107
SP - 709
EP - 713
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 5
ER -