Simulated Obstructive Sleep Apnea Increases P-Wave Duration and P-Wave Dispersion |
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Authors: | Thomas Gaisl Annette M Wons Valentina Rossi Daniel J Bratton Christian Schlatzer Esther I Schwarz Giovanni Camen Malcolm Kohler |
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Affiliation: | 1Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland;2Spital Zollikerberg, Zollikerberg, Switzerland;3Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland;4Centre for Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland;Charité - Universitätsmedizin Berlin, GERMANY |
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Abstract: | BackgroundA high P-wave duration and dispersion (Pd) have been reported to be a prognostic factor for the occurrence of paroxysmal atrial fibrillation (PAF), a condition linked to obstructive sleep apnea (OSA). We tested the hypothesis of whether a short-term increase of P-wave duration and Pd can be induced by respiratory manoeuvres simulating OSA in healthy subjects and in patients with PAF.Methods12-lead-electrocardiography (ECG) was recorded continuously in 24 healthy subjects and 33 patients with PAF, while simulating obstructive apnea (Mueller manoeuvre, MM), obstructive hypopnea (inspiration through a threshold load, ITH), central apnea (AP), and during normal breathing (BL) in randomized order. The P-wave duration and Pd was calculated by using dedicated software for ECG-analysis.ResultsP-wave duration and Pd significantly increased during MM and ITH compared to BL in all subjects (+13.1ms and +13.8ms during MM; +11.7ms and +12.9ms during ITH; p<0.001 for all comparisons). In MM, the increase was larger in healthy subjects when compared to patients with PAF (p<0.05).ConclusionIntrathoracic pressure swings through simulated obstructive sleep apnea increase P-wave duration and Pd in healthy subjects and in patients with PAF. Our findings imply that intrathoracic pressure swings prolong the intra-atrial and inter-atrial conduction time and therefore may represent an independent trigger factor for the development for PAF. |
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