Table 3– Ventricular arrhythmias
First author [ref.]Study designSubjects nPopulation characteristicsMain findings
Observational studies
 Tilkian [72]OBS15OSA66% prevalence of nocturnal VPC
 Miller [96]OBS23OSADecrease in number of ventricular ectopy episodes from wakefulness to sleep
 Guilleminault [23]OBS400OSA19% prevalence of nocturnal VPC
 Shepard [24]OBS31OSA74% prevalence of VPC, related to oxygen desaturation <60%
 Hoffstein [71]OBS458OSA58% 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]OBS45OSA17.7% prevalence of significant nocturnal rhythm disturbances
Correlation between AHI and dysrhythmias
 Fichter [93]OBS38Impaired LVEF, treated with cardioverter-defibrillator41% prevalence of SDB
VPCs occurred significantly more often during SDB than during normal respiration
 Alonso-Fernández [46]CC21OSANo differences in daytime and nocturnal dysrhythmias
Patients with OSA have more sinus tachycardia, SVPC, NSVT and ventricular couplets
12Snorers without hypersomnolence
15Healthy controls
 Mehra [10]CC228Patients with SDB (RDI ≥30 events·h−1)5.3% prevalence of NSVT (OR=3.4)
25% prevalence of VPC (OR=1.74)
338Controls without SDB (RDI <5 events·h−1)
 Olmetti [11]OBS257OSA9% prevalence of complex ventricular arrhythmias
 Ryan [91]OBS20Patients with OSA, HF and ≥30 VPCs per hourVPCs occur mainly during the apnoeic phase
 Koshino [90]OBS35Medications, catheter ablation or implantation of cardioverter-defibrillator due to ventricular arrhythmias60% prevalence of AHI ≥5 events·h−1
34% prevalence of moderate-to-severe OSA (average AHI 33.6 events·h−1)
 Bitter [94]OBS472Congestive HF66% 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]OBS35Patients with ventricular tachycardia or VPCs without structural heart disease, undergoing catheter ablation therapy45% incidence of dysrhythmia relapse in patients with AHI ≥10 events·h−1 versus 6% in patients without OSA
 Namtvedt [1]OBS486General population56% 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]INT15OSAAtropine partially and tracheostomy almost completely prevented VPCs during sleep
 Harbison [97]INT45OSANasal CPAP therapy abolished arrhythmias in 88%
 Ryan [98]RCT18OSA and heart failure Therapeutic CPAP versus no therapy58% reduction of nocturnal VPCs after 1 month of CPAP
 Craig [70]RCT83OSA
Therapeutic CPAP versus sub-therapeutic CPAP
Trend towards less daytime ventricular tachycardia in the therapeutic CPAP group
 Rossi [89]RCT41OSA
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.