Abstract 2112: Impact of Sleep-Disordered Breathing on Life-Threatening Ventricular Arrhythmia in Patients with Dilated Cardiomyopathy
It is suggested that sleep-disordered breathing (SDB) is associated with cardiac arrhythmia and sudden cardiac death. However, it remains unclear whether the presence of SDB increases risk of life-threatening ventricular arrhythmia in pts with dilated cardiomyopathy (DCM).
Methods: We prospectively studied consecutive 65 pts with DCM, who were followed for 6 months from the time of sleep study. All patients had LVEF < 40% and received implantable cardioverter-defibrillator (ICD). SDB was defined as an apnea hypopnea index (AHI) ≥10/hr by polysomnography. Clinical characteristics at baseline, the frequency of appropriate ICD therapy due to life-threatening ventricular arrhythmia, and day-night pattern of ICD therapy were compared between pts with and without SDB.
Results: SDB were diagnosed 42 pts out of 65 pts (37 obstructive sleep apnea, 5 central sleep apnea). There were no statistical differences between pts with and without SDB in NYHA, underlying disease, LVEF, plasma BNP levels, and medication use at baseline. However, the ICD therapy were more frequently occurred seen in pts with SDB than those without SDB (40% vs.17%, P<0.05, Figure A⇓). Multivariate analysis elucidated that the presence of SDB was an independent predictor for occurrence of ICD therapy (HR 3.8, P<0.05). Moreover, as for day-night pattern of ICD therapy, the rate of total ICD therapy from midnight to 6 a.m. was significantly higher in pts with SDB than those without SDB (39% vs. 19%, P<0.05, Figure B⇓).
Conclusions: The present study showed that in pts with DCM, the presence of SDB was an independent predictor for life-threatening ventricular arrhythmia, that was more frequently happened during night.