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Relationship between atrial conduction delay and obstructive sleep apnea

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Abstract

Prolonged P-wave duration, indicating atrial conduction delay, is a marker of left atrial abnormality and is reported as a potent precursor of atrial fibrillation (AF). Several studies have shown that obstructive sleep apnea (OSA) is associated with AF. We evaluated the relationship between OSA and prolonged P-wave duration. Consecutive subjects who underwent overnight polysomnography and showed a normal sinus rhythm, had no history of AF or ischemic heart disease, and showed no evidence of heart failure were enrolled. Apnea–hypopnea index (AHI) is defined as the number of apnea and hypopnea events per hour of sleep. P-wave duration was determined on the basis of the mean duration of three consecutive beats in lead II from a digitally stored electrocardiogram. A total of 250 subjects (middle-aged, predominantly male, mildly obese, with a mean P-wave duration of 106 ms) were enrolled. In addition to age, male gender, body mass index (BMI), hypertension, dyslipidemia, and uric acid and creatinine levels, AHI (r = 0.56; P < 0.001) had significant univariable relationship with P-wave duration. Multivariate regression analysis showed that age, BMI, male gender, and AHI (partial correlation coefficient, 0.47; P < 0.001) were significantly independently correlated to P-wave duration. Severity of OSA is significantly associated with delayed atrial conduction time. Obstructive sleep apnea may lead to progression of atrial remodeling as an AF substrate.

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Authors and Affiliations

  1. Sleep Center, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan

    Ken-ichi Maeno, Takatoshi Kasai, Satoshi Kasagi, Fusae Kawana & Koji Narui

  2. Toranomon Sleep Clinic, Tokyo, Japan

    Ken-ichi Maeno

  3. Cardio-Respiratory Sleep Medicine, Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan

    Takatoshi Kasai

  4. Cardiovascular Center, Toranomon Hospital, Tokyo, Japan

    Sugao Ishiwata, Minoru Ohno & Tetsu Yamaguchi

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  1. Ken-ichi Maeno
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  2. Takatoshi Kasai
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Correspondence to Takatoshi Kasai.

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Maeno, Ki., Kasai, T., Kasagi, S. et al. Relationship between atrial conduction delay and obstructive sleep apnea. Heart Vessels 28, 639–645 (2013). https://doi.org/10.1007/s00380-012-0288-8

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  • DOI: https://doi.org/10.1007/s00380-012-0288-8

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