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Arrhythmia Risk Associated with Sleep Disordered Breathing in Chronic Heart Failure

  • Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise (AK Hasan, Section Editor)
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Abstract

The intersecting relationships of sleep disordered breathing (SDB), arrhythmogenic risk and chronic heart failure (HF) are complex and most likely multi-directional and synergistic. Autonomic dysfunction is a common pathophysiological feature of each of these entities. Intermittent hypoxia, hypercapnia, mechanical cardiac influences due to upper airway obstruction and rostral fluid shifts are SDB-specific mechanisms which may trigger, perpetuate and exacerbate HF and arrhythmogenesis. Specific pathophysiological mechanisms will vary according to the predominance of central as compared to obstructive sleep apnea. The risk of cardiac arrhythmias and HF attributable to SDB may be considerable given the high prevalence of SDB and its likely physiologic burden. The current review focuses on the data, which have accrued elucidating the specific contributory mechanisms of SDB in cardiac arrhythmias and HF, highlighting the clinical relevance and effects of standard SDB treatment on these outcomes, and describing the role of novel therapeutics.

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Conflict of Interest

Reena Mehra has received financial support through a grant from the National Institutes of Health (NIH); has received compensation from CareCore for service as a board member; has received payment for lectures including service on speakers bureaus from the American Academy of Sleep Medicine.

Susan Redline has received compensation from the American Academy of Sleep Medicine for service as a board member.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Cleveland Clinic, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, 44195, USA

    Reena Mehra

  2. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Susan Redline

  3. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Susan Redline

  4. 221 Longwood Avenue BLI 438, Boston, MA, 02115, USA

    Susan Redline

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  1. Reena Mehra
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Correspondence to Reena Mehra.

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Mehra, R., Redline, S. Arrhythmia Risk Associated with Sleep Disordered Breathing in Chronic Heart Failure. Curr Heart Fail Rep 11, 88–97 (2014). https://doi.org/10.1007/s11897-013-0171-7

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