Key result
CPAP therapy in OHS is linked to ~30% shorter inter-atrial electromechanical delay and fewer AF episodes.
Why the study?
Does CPAP therapy improve atrial electromechanical delay and reduce atrial fibrillation incidence in patients with obesity-hypoventilation syndrome?
Cohort (n=100)
Does CPAP therapy improve atrial electromechanical delay and reduce atrial fibrillation incidence in patients with obesity-hypoventilation syndrome?
CPAP therapy significantly improves atrial conduction heterogeneity and reduces paroxysmal atrial fibrillation episodes in patients with obesity-hypoventilation syndrome.
Impact of Continuous Positive Airway Pressure Background Obesity‐hypoventilation syndrome (OHS) is defined as daytime hypercapnia and hypoxemia in obese patients with sleep‐disordered breathing. We evaluated the electrocardiographic P‐wave duration and dispersion (PD) and echocardiographic noninvasive indicators of atrial conduction heterogeneity in OHS patients and the impact of CPAP on atrial conduction and atrial fibrillation incidence. Methods and Results We enrolled 50 OHS patients and 50 sex‐ and age‐matched obese subjects as control. Study population underwent cardiologic evaluation and polysomnography before enrollment, at 1‐ and 6‐month follow‐ups after CPAP therapy. The OHS group showed a significant increase in inter‐atrial (35.2 ± 8 milliseconds vs. 20.1 ± 2.7 milliseconds, P < 0.0001), intra‐left (30.5 ± 7.2 milliseconds vs. 16.5 ± 2 milliseconds, P < 0.0001), and intra‐right atrial electromechanical delays (AEMD)(24.8 ± 10 milliseconds vs. 15 ± 2.6 milliseconds, P < 0.0001) as well as in Pmax (130 ± 7.4 milliseconds vs. 97 ± 7.2 milliseconds, P = 0.002) and PD (56.5 ± 8.5 milliseconds vs. 31 ± 7.2 milliseconds, P = 0.002) compared to the control group. Significant improvement was noted after 6 months of CPAP therapy in inter‐atrial (35.2 ± 8 milliseconds vs. 24.5 ± 6.3 milliseconds, P < 0.0001), intra‐left (30.5 ± 7.2 milliseconds vs. 20.6 ± 5 milliseconds, P = 0.003), and intra‐right AEMD (24.8 ± 10 milliseconds vs. 17 ± 7.5 milliseconds, P < 0.0001), as well as in Pmax (130 ± 7.4 milliseconds vs. 95 ± 10 milliseconds, P < 0.0001) and in PD (56.5 ± 8.5 milliseconds vs. 32.5 ± 6 milliseconds, P < 0.0001) in the OHS group. External loop recorder monitoring detected paroxysmal AF in 19 OHS patients (38%) with significant reduction in paroxysmal AF episodes (12 ± 6 vs. 47 ± 12, P < 0.0001) after 6‐month CPAP therapy. Conclusion Our findings showed a significant increase of electrocardiographic and echocardiographic indexes of atrial conduction heterogeneity in OHS patients. The CPAP therapy, having a positive impact on atrial conduction time, seems to reduce AF incidence in OHS patients
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Russo et al. (2015) conducted a cohort in Obesity-hypoventilation syndrome (n=100). Continuous Positive Airway Pressure (CPAP) therapy vs. Baseline (pre-CPAP) was evaluated on Inter-atrial electromechanical delay (AEMD) (p=<0.0001). CPAP therapy for 6 months significantly reduced inter-atrial electromechanical delay (35.2 vs 24.5 ms, P<0.0001) and paroxysmal AF episodes (47 vs 12, P<0.0001) in OHS patients.
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