Abstract 20638: Obstructive Sleep Apnea causes Interatrial Conduction Delay
Background: Prolonged P wave duration, which means interatrial conduction delay (ICD), is a marker of left atrial abnormality and reported as a potent precursor of atrial fibrillation (AF). On the other hand, several studies showed obstructive sleep apnea (OSA) was associated with AF. We assessed the hypothesis that OSA causes ICD.
Methods: Consecutive 250 subjects who underwent overnight polysomnography under the suspicion of OSA, with normal sinus rhythm, no history of AF or ischemic heart disease, or no evidence of heart failure were enrolled. P wave duration was determined as the mean duration of three consecutive beats in lead II from the digitally-stored electrocardiogram. An ICD defined by New York Heart Association criteria as a P wave duration >/=110 ms. Subjects were classified into two groups; ICD group and control group, and logistic regression analysis was performed to determine the related factors for ICD.
Results: ICD was observed in 93 (37 %). P wave duration was correlated with apnea hypopnea index (AHI; r=0.56, p<0.001). Compared with control group, ICD group was significantly older (51±13 vs 55±13 year-old, p=0.017), revealed higher level of body mass index (25.3±3.9 vs 27.2±4.0, p<0.001), AHI (26.5±21.1 vs 48.1±20.6 /hr, p<0.001), percentage of SO2<90% during sleep (11.3±17.9 vs 29.4±29.5 %, P<0.001), and included more number of those with hypertension (32 vs 56 %, p<0.001) and male gender (85 vs 97 %, p=0.009). In multivariate logistic regression analysis including age, gender, body mass index, hypertension, diabetes, dyslipidemia, uric acid, C-reactive protein, AHI (per 10 /hr) and percentage of desaturation time during sleep as an independent variables, age (oddw ratio 1.04, p=0.008) and AHI (odds ratio 1.54, p<0.001) were significantly associated with ICD.
Conclusions: Severity of OSA was significantly associated with delayed interatrial conduction time. These suggest that OSA might lead to progression in atrial remodeling as a substrate for AF.
- © 2010 by American Heart Association, Inc.