Impact of ventricular arrhythmia during polysomnography in patients with sleep apnea on transient ischemic attack and autonomic dysfunction
S I ImAbstract
Background
Obstructive sleep apnea (OSA) are associated with cardiac arrhythmia.
Purpose
The purpose of this study was to explore the temporal association between OSA and ventricular arrhythmia, as well as their impact on transient ischemia attack/stroke in OSA patients.
Methods
We prospectively studied 91 consecutive patients with a confirmed diagnosis of OSA between May 2023 and February 2025. Polysomnography (PSG) and ambulatory electrocardiography (ECG, S-patch) were performed on all patients simultaneously. And we compared PSG parameters, respiratory events according to ventricular arrhythmia.
Results
Among 91patients with OSA (78.4±9.7 years), 40 (43.9%) patients had premature ventricular complex (PVC). Difference in the baseline characteristics was not observed among patients in both groups except age, gender according to PVC. During PSG and S-patch, maximal RR interval (P=0.003), total apnea index (P=0.036), Total apnea hypopnea index (AHI, P=0.027) and non-REM AHI (P=0.013) were higher in PVC group compared to non-PVC group. In univariate analysis, body weight, PVC group, respiratory effort-related arousals in supine position during sleeping (RERAs-supine) and O2 saturation decrease during asleep were associated with transient ischemia attack/stroke. In multivariate analysis, PVC group was independent risk factors for transient ischemia attack/stroke (OR 22.322; CI 1.139-437.882; P=0.041).
Conclusions
Lower heart rate, worse PSG indexes were associated with PVC occurrence during sleeping. And PVC during sleeping was significantly associated with transient ischemic attack/stroke in OSA patients, supporting the need for PVC treatment tailored to specific clinical features of OSA patients.