Relationship between atrial conduction delay and obstructive sleep apnea

Heart Vessels. 2013 Sep;28(5):639-45. doi: 10.1007/s00380-012-0288-8. Epub 2012 Sep 14.

Abstract

Prolonged P-wave duration, indicating atrial conduction delay, is a marker of left atrial abnormality and is reported as a potent precursor of atrial fibrillation (AF). Several studies have shown that obstructive sleep apnea (OSA) is associated with AF. We evaluated the relationship between OSA and prolonged P-wave duration. Consecutive subjects who underwent overnight polysomnography and showed a normal sinus rhythm, had no history of AF or ischemic heart disease, and showed no evidence of heart failure were enrolled. Apnea-hypopnea index (AHI) is defined as the number of apnea and hypopnea events per hour of sleep. P-wave duration was determined on the basis of the mean duration of three consecutive beats in lead II from a digitally stored electrocardiogram. A total of 250 subjects (middle-aged, predominantly male, mildly obese, with a mean P-wave duration of 106 ms) were enrolled. In addition to age, male gender, body mass index (BMI), hypertension, dyslipidemia, and uric acid and creatinine levels, AHI (r = 0.56; P < 0.001) had significant univariable relationship with P-wave duration. Multivariate regression analysis showed that age, BMI, male gender, and AHI (partial correlation coefficient, 0.47; P < 0.001) were significantly independently correlated to P-wave duration. Severity of OSA is significantly associated with delayed atrial conduction time. Obstructive sleep apnea may lead to progression of atrial remodeling as an AF substrate.

MeSH terms

  • Action Potentials
  • Adult
  • Aged
  • Arrhythmias, Cardiac / complications*
  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / physiopathology
  • Atrial Function, Left*
  • Body Mass Index
  • Cross-Sectional Studies
  • Electrocardiography
  • Female
  • Heart Conduction System / physiopathology*
  • Humans
  • Japan
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity / complications
  • Obesity / diagnosis
  • Polysomnography
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / etiology*
  • Sleep Apnea, Obstructive / physiopathology
  • Time Factors