Simulated Obstructive Sleep Apnea Increases P-Wave Duration and P-Wave DispersionReport as inadecuate




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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 +13.1ms 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.

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.



Author: Thomas Gaisl, Annette M. Wons, Valentina Rossi, Daniel J. Bratton, Christian Schlatzer, Esther I. Schwarz, Giovanni Camen, Malcol

Source: http://plos.srce.hr/



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