Recurrent paroxysmal atrial fibrillation induced by marked hypoxia during sleep-disordered breathing

Publication date: Available online 3 June 2016 Source:Journal of Cardiology Cases Author(s): Tomoyuki Tobushi, Shin-ichi Ando, Toshiaki Kadokami Sleep-disordered breathing (SDB) has a big impact on autonomic nervous activity and thus induces or deteriorates various cardiovascular diseases. We here describe a typical but rarely documented case which clearly indicates a strong link between SDB and cardiovascular disease. A 68-year-old woman complaining of frequent palpitations was referred to our institute. An electrocardiogram (ECG) at a previous clinic had shown atrial fibrillation, although it had already returned to sinus rhythm on arrival at our institute. Her body mass index was 32.5kg/m2 and she had a history of loud snoring. Simultaneous examinations of Holter ECG monitoring and ambulatory polysomnography (PSG) showed onset of paroxysmal atrial fibrillation following marked oxygen desaturation at midnight. In-hospital PSG revealed severe obstructive sleep apnea. A new device with desaturation triggered ambulatory blood pressure monitoring system performed 1 week later again showed a midnight onset of paroxysmal atrial fibrillation coincided with surge of blood pressure with marked desaturation. Her recurrence of palpitations had obviously decreased by continuous positive airway pressure therapy thereafter. <Learning objective: A clinician should suspect sleep-disordered breathing (SDB) behind cardiac arrhythmia, especially if it is nocturnal. Nocturnal ...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research