阻塞性睡眠呼吸暂停低通气综合征合并夜间心律失常患者对无创通气治疗的反应报告

目的:评估阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea-hypopnea Syndrome,OSAHS)合并夜间缓慢型心律失常或心房颤动、房扑、频发室性早搏的患者行持续无创正压通气治疗后(Continuous Positive Airway Pressure,CPAP)临床症状、睡眠呼...

Report on Clinical Observation of Noninvasive Ventilation in Patients with Obstructive Sleep Apnea Hypopnea Syndrome Complicated with Noctural Arrhythmia

Objective:To evaluate the clinical symptoms,sleep apnea hypopnea index(AHI)of patients with obstructive sleep apnea hypopnea syndrome(OSAHS)complicated with nocturnal bradyarrhythmia or atrial fibrillation,atrial flutter and frequent ventricular premature beats after continuous positive airway pressure(CPAP).To explore the mechanism and effective treatment of nocturnal arrhythmia in patients with OSAHS.Methods:Forty patients with severe OSAHS complicated with nocturnal bradyarrhythmia,atrial flutter and atrial fibrillation confirmed by polysomnography(PSG)were examined by PSG and 24-hour ambulatory electrocardiogram(Holter).After CPAP treatment for 3 days,PSG and Holter were rechecked while wearing ventilator.Results:A total of 40 patients were diagnosed as severe OSAHS after PSG and Holter examination at the same time.Holter confirmed that 25 cases had gradeⅡatrioventricular block at night,2 cases had sinus arrest at night,of which 1 case had the longest R-R interval of 5.1 seconds,8 cases had paroxysmal atrial flutter and atrial fibrillation at night,and 5 cases had frequent ventricular premature beats at night.PSG and Holter were rechecked in 40 patients during CPAP treatment.The clinical symptoms were significantly improved,AHI decreased to normal,the average oxygen saturation at night was normal,the majority of atrioventricular block,all the paroxysmal atrial flutter,atrial fibrillation and frequent ventricular premature beats disappeared.Conclusion:Hypoxia and vagus nerve excitation are the main mechanisms of nocturnal arrhythmia in patients with OSAHS.CPAP can effectively eliminate nocturnal arrhythmia in patients with OSAHS complicated with nocturnal arrhythmia.