Is obstructive sleep apnea associated with ventricular tachycardia? A retrospective study from the National Inpatient Sample and a literature review on the pathogenesis of Obstructive Sleep Apnea

Clin Cardiol. 2018 Dec;41(12):1543-1547. doi: 10.1002/clc.23092. Epub 2018 Nov 24.

Abstract

Background: Obstructive sleep apnea (OSA) is a known independent risk factor for a multiple cardiovascular morbidities and mortality. The association of OSA and ventricular arrhythmias is less well understood. The aim of this analysis is to study the relationship between OSA and ventricular tachyarrhythmias.

Hypothesis: OSA is associated with increased ventricular arrhythmias.

Methods: Data from the national inpatient sample (NIS) 2012 to 2014, were reviewed. Discharges associated with OSA were identified as the target population using the relevant ICD-9-CM codes. The primary outcome was a diagnosis of ventricular tachycardia (VT) in the OSA population. Secondary outcomes include the rate of ventricular fibrillation (VF) and cardiac arrest. Multivariable analyses were performed to examine the association of VT with multiple potential confounding clinical variables.

Results: Of 18 013 878 health encounters, 943 978 subjects (5.24%) had a diagnosis of OSA. VT and VF were more prevalent among patients with OSA compared to those without a diagnosis of OSA (2.24% vs 1.16%; P < 0.001 and 0.3% vs 0.2%; P < 0.001, respectively). Odds ratio for cardiac arrest in OSA group was not statistically significant (1, 95% confidence interval 0.97-1.02, P < 0.76). In unadjusted analyses, all examined comorbidities were significantly more common in those with OSA, including diabetes mellitus, hypertension, chronic kidney disease, acute coronary syndrome, and heart failure.

Conclusion: OSA is associated with increased rates of ventricular tachyarrhythmia.

Keywords: obstructive sleep apnea (OSA); ventricular arrhythmias; ventricular fibrillation (VF); ventricular tachycardia (VT).

Publication types

  • Review

MeSH terms

  • Global Health
  • Humans
  • Inpatients*
  • Prevalence
  • Risk Assessment / methods*
  • Risk Factors
  • Sleep Apnea, Obstructive / complications*
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Apnea, Obstructive / physiopathology
  • Survival Rate / trends
  • Tachycardia, Ventricular / epidemiology
  • Tachycardia, Ventricular / etiology*
  • Tachycardia, Ventricular / physiopathology
  • Time Factors