Simulated Obstructive Sleep Apnea Increases P-Wave Duration and P-Wave Dispersion.
- Gaisl T Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- Wons AM Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- Rossi V Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- Bratton DJ Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- Schlatzer C Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- Schwarz EI Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- Camen G Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- Kohler M Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
- 2016-04-13
Published in:
- PloS one. - 2016
Adolescent
Adult
Aged
Atrial Fibrillation
Case-Control Studies
Electrocardiography
Female
Heart Rate
Humans
Male
Middle Aged
Models, Biological
Pressure
Risk Factors
Sleep Apnea, Central
Sleep Apnea, Obstructive
Young Adult
English
BACKGROUND
A 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.
METHODS
12-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.
RESULTS
P-wave duration and Pd significantly increased during MM and ITH compared to BL in all subjects (+13.1 ms and +13.8 ms during MM; +11.7 ms and +12.9 ms 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).
CONCLUSION
Intrathoracic 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.
A 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.
METHODS
12-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.
RESULTS
P-wave duration and Pd significantly increased during MM and ITH compared to BL in all subjects (+13.1 ms and +13.8 ms during MM; +11.7 ms and +12.9 ms 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).
CONCLUSION
Intrathoracic 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.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1371/journal.pone.0152994
- PMID 27071039
- Persistent URL
- https://sonar.ch/global/documents/35866
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