OSA patients with greater hypoxia and higher AHI had more supraventricular arrhythmias and fewer ventricular arrhythmias despite similar cardiovascular histories.
Does arrhythmic phenotyping using a multi-diagnostic chest-worn monitor identify distinct clinical clusters in patients with obstructive sleep apnea?
Integrating arrhythmic phenotyping into home sleep apnea testing can identify distinct patient clusters, potentially enhancing cardiovascular risk stratification for atrial fibrillation progression.
Absolute Event Rate: 0% vs 0%
Abstract Background Obstructive sleep apnea (OSA) is closely linked to arrhythmias and cardiovascular complications. Current OSA diagnosis relies on the one-dimensional apnea-hypopnea index (AHI), but recent evidence highlights distinct phenotypes with varying cardiovascular risk. Notably, nocturnal hypoxia is increasingly recognized as a driver of incident atrial fibrillation (AF) in OSA populations. Incorporating nocturnal arrhythmic burden into OSA phenotyping could improve AF risk predication but remains underexplored. Purpose To investigate the clustering behavior of arrhythmias in OSA patients. Methods Overnight sleep data were collected from 111 OSA patients (AHI≥5) using a multi-diagnostic chest-worn monitor that records ECG, oximetry, and respiratory parameters to simultaneously diagnose OSA and arrhythmias. Principal Component Analysis and Hierarchical Cluster Analysis were used to reduce dimensionality and identify two distinct groups based on demographics, medical histories, detected arrhythmias, and automated sleep test results. Results Cluster 1 (N=42) and Cluster 2 (N=69) were similar in age, sex, race, and history of cardiovascular, electrophysiological, and metabolic disorders. Cluster 2 exhibited higher BMI, more respiratory comorbidities, more supraventricular arrhythmias, fewer ventricular arrhythmias, higher AHI, longer total sleep time, and greater hypoxia. Statistical differences were not observed between groups. Conclusions Patients with OSA who experienced greater hypoxia and had a higher AHI were found to have more supraventricular arrhythmias and fewer ventricular arrhythmias despite similar cardiovascular and electrophysiological history. As supraventricular arrhythmias are associated with AF progression, these findings suggest that arrhythmic burden could enhance cardiovascular risk stratification in OSA patients. The potential value of integrating arrhythmic phenotyping into scalable home sleep apnea testing using a multi-diagnostic chest-worn monitor was established. Larger studies are needed to confirm findings and explore mechanistic links between arrhythmias and hypoxia in OSA.
Sargeant et al. (Sat,) reported a other. OSA patients with greater hypoxia and higher AHI had more supraventricular arrhythmias and fewer ventricular arrhythmias despite similar cardiovascular histories.