The Incidence Of Arrhythmia In Patients With Obstructive Sleep Apnea Syndrome And Its Correlation With Heart Rate Variability And Deceleration Capacity

Objective:To analyze the occurrence of arrhythmia in patients with obstructive sleep apnea hypopneasyndrome(OSAHS)in all day(24h)and all night(7h),and to explore the possible mechanism of arrhythmia,and then analyzing its correlation with heart rate variability(HRV)and deceleration capacity(DC).Methods:A total of 250 patients with nocturnal sleep snoring who were hospitalized at Gansu Provincial Hospital from January 2016 to December 2017 were involved in this study.38 patients were excluded who did not meet the inclusion criteria,212 patients were selected in this study in the end.The study have 185(87.3%)men and 27(12.7%)females.Polysomnogra-phy(PSG)and holter were performed in all included participants.The diagnostic criteria and grouping criteria of OSAHS refer tothe guidelines for the diagnosis and treatment of obstructive sleep apnea hypopnea syndrome that the Chinese Medical Association revised(2011).According to the apnea hypopnea index(AHI),the participants were divided into the control group(AHI<5)and OSAHS group(AHI?5),moreover,the OSAHS group was divided into mild to moderate group(5?AHI?30)and severe group(AHI>30),and to observe the occurrence of arrhythmia in patients with OSAHS in all day(24h)and all night(7h),and to analyze the differences in heart rate variability(HRV)and deceleration capacity(DC)among groups.All of the data were analyzed by SPSS20.0 statistical software.P value of less than 0.05 would be considered statistically significant.Results:1.There were no significant differences in age,gender,and BMI among the three groups.There were no significant differences in systolic and diastolic blood pressure before PSG.Theincidence of hypertension,diabetes,coronary heart disease,and dyslipidemia was not statistically different among the three groups.2.The incidence of the artrial tachycardia and sinus bradycardia of severe group was significantly higher than that of mild to moderate group(P<0.05).The proportion oftheparoxysmal atrial tachycardia frequency <10 array in the mild to moderate group and the severe group was significantly higher than that in the control group.(P<0.05).The incidence of nocturnal arrhythmias in the control group,mild-to-moderate group and severe group were compared.The incidence of sinus arrhythmia in the severe group was higher than that in the mild-to-moderate group(P<0.05).3.HRV parameters(including SDNN,SDANN Index,SDNN Index,rMSSD,LF,HF,LF/HF),among three groups only SDNN differed significantly,and the difference between the severe group and the control group was significant(p<0.05).The difference between SDNN and heart rate deceleration were statistically significant between the severe group and the control group(p<0.05).4.The average time of total oxygen saturation,minimum oxygen saturation,oxygen deprivation index(ODI),and blood oxygen less than 90% of total sleep time(T90)were statistically significant among the three groups and the difference between the severe group and the mild to moderate group was also statistically significant.The difference of minimum oxygen saturation and ODI between the severe group and the control group were statistically significant.5.In the correlation analysis,the low frequency(LF),high frequency(HF),and deceleration capacityof OSAHS patients were positively correlated with AHI,andT90 was positively correlated with SDNN and HF,but were negatively correlated with deceleration capacity.Conclusions:1.OSAHS patients are more prone to arrhythmia,Severe group has a higher incidence than mild to moderategroup.2.Autonomic nerve dysfunction in OSAHS patients maybe an important factors of occurance of arrhythmia.3.The PSG parameters such as AHI and T90 of OSAHS patients are closely related to HRV parameters and DC.