First author [ref.] | Study design | Subjects n | Population characteristics | Main findings |
Observational studies | ||||
Tilkian [72] | OBS | 15 | OSA | 66% prevalence of nocturnal VPC |
Miller [96] | OBS | 23 | OSA | Decrease in number of ventricular ectopy episodes from wakefulness to sleep |
Guilleminault [23] | OBS | 400 | OSA | 19% prevalence of nocturnal VPC |
Shepard [24] | OBS | 31 | OSA | 74% prevalence of VPC, related to oxygen desaturation <60% |
Hoffstein [71] | OBS | 458 | OSA | 58% prevalence of VPC and SVPC for AHI >10 events·h−1 versus 42% in subjects without OSA 82% prevalence of VPC and SVPC for mean nocturnal oxygenation <90% |
Harbison [97] | OBS | 45 | OSA | 17.7% prevalence of significant nocturnal rhythm disturbances Correlation between AHI and dysrhythmias |
Fichter [93] | OBS | 38 | Impaired LVEF, treated with cardioverter-defibrillator | 41% prevalence of SDB VPCs occurred significantly more often during SDB than during normal respiration |
Alonso-Fernández [46] | CC | 21 | OSA | No differences in daytime and nocturnal dysrhythmias Patients with OSA have more sinus tachycardia, SVPC, NSVT and ventricular couplets |
12 | Snorers without hypersomnolence | |||
15 | Healthy controls | |||
Mehra [10] | CC | 228 | Patients with SDB (RDI ≥30 events·h−1) | 5.3% prevalence of NSVT (OR=3.4) 25% prevalence of VPC (OR=1.74) |
338 | Controls without SDB (RDI <5 events·h−1) | |||
Olmetti [11] | OBS | 257 | OSA | 9% prevalence of complex ventricular arrhythmias |
Ryan [91] | OBS | 20 | Patients with OSA, HF and ≥30 VPCs per hour | VPCs occur mainly during the apnoeic phase |
Koshino [90] | OBS | 35 | Medications, catheter ablation or implantation of cardioverter-defibrillator due to ventricular arrhythmias | 60% prevalence of AHI ≥5 events·h−1 34% prevalence of moderate-to-severe OSA (average AHI 33.6 events·h−1) |
Bitter [94] | OBS | 472 | Congestive HF | 66% prevalence of SDB Independent association between OSA and ventricular arrhythmias: HR 1.69 for AHI ≥5 events·h−1 HR 1.69 for AHI≥15 events·h−1 |
Koshino [95] | OBS | 35 | Patients with ventricular tachycardia or VPCs without structural heart disease, undergoing catheter ablation therapy | 45% incidence of dysrhythmia relapse in patients with AHI ≥10 events·h−1 versus 6% in patients without OSA |
Namtvedt [1] | OBS | 486 | General population | 56% prevalence of OSA 12.2% nocturnal prevalence of VPCs in patients with OSA compared to 4.7% in subjects without OSA 14% diurnal prevalence of VPCs in patients with OSA compared to 5.1% in subjects without OSA |
Interventional studies | ||||
Tilkian [72] | INT | 15 | OSA | Atropine partially and tracheostomy almost completely prevented VPCs during sleep |
Harbison [97] | INT | 45 | OSA | Nasal CPAP therapy abolished arrhythmias in 88% |
Ryan [98] | RCT | 18 | OSA and heart failure Therapeutic CPAP versus no therapy | 58% reduction of nocturnal VPCs after 1 month of CPAP |
Craig [70] | RCT | 83 | OSA Therapeutic CPAP versus sub-therapeutic CPAP | Trend towards less daytime ventricular tachycardia in the therapeutic CPAP group |
Rossi [89] | RCT | 41 | OSA Therapeutic CPAP versus sub-therapeutic CPAP | 55% patients in the sub-therapeutic CPAP group shifted to TpTe values >100 ms and 71% shifted to QTc values >430 ms Increase in QTc, TpTec intervals and TpTe/QT ratio Correlation between AHI and QTc and TpTe |
OBS: observational study; OSA: obstructive sleep apnoea; VPC: ventricular premature complex; SVPC: supraventricular premature complex; AHI: apnoea/hypopnoea index; LVEF: left ventricular ejection fraction; SDB: sleep disordered breathing; CC: case–control study; NSVT: non-sustained ventricular tachycardia; RDI: respiratory disturbance index; HF: heart failure; INT: interventional uncontrolled study; CPAP: continuous positive airway pressure; RCT: randomised controlled study; TpTe: Tpeak to Tend interval; QTc: QT interval corrected for heart rate; TpTec: TpTe corrected for heart rate.