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Schlafbezogene Atmungsstörungen und kardiale Arrhythmien

Sleep-related breathing disorders and cardiac arrhythmias

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Zusammenfassung

Schlafbezogene Atmungsstörungen sind eine häufige und klinisch relevante Komorbidität bei Patienten mit Herzrhythmusstörungen. Eine erhöhte Inzidenz ebenso wie ein vorzeitiges Wiederauftreten von Vorhofflimmern nach elektrischer Kardioversion oder Katheterablation gilt bei Patienten mit unbehandelter schlafbezogener Atmungsstörung als gesichert. Bei herzinsuffizienten Patienten scheint es zu häufigerem und vorzeitigem Auftreten lebensbedrohlicher Arrhythmien zu kommen. Die obstruktive, schlafbezogene Atmungsstörung (OSA) gilt als Risikofaktor für den plötzlichen Herztod, der hier gehäuft während des Schlafes auftritt. Während erste Studien positive Effekte auf die Arrhythmieneigung bei Patienten mit OSA unter kontinuierlicher Überdruckbeatmung nachweisen konnten, stehen randomisierte Studien für die positive Beeinflussung von Arrhythmien bei Patienten mit Cheyne-Stokes-Atmung noch aus.

Abstract

Sleep-disordered breathing is a highly prevalent and clinically relevant co-morbidity in patients with heart rhythm disorders. An increased incidence of atrial fibrillation as well as a premature reoccurrence of atrial fibrillation following electrical cardioversion or catheter ablation has previously been demonstrated. Patients with chronic heart failure seem to face an increased risk for malignant arrhythmic events. Furthermore, in patients with obstructive sleep apnea sudden cardiac death occurs more frequently during sleeping hours. Preliminary data suggest beneficial effects on arrhythmia occurrence in patients with obstructive sleep apnea (OSA) undergoing continuous positive airway pressure. However, as in patients with Cheyne-Stokes respiration, randomized, controlled trial results for ventilation therapy are still lacking.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Bitter und O. Oldenburg erhielten Vortragshonorare von der Firma ResMed. D. Horstkotte hat keine Interessenkonflikte.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Kardiologie, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universität Bochum, Bochum, Deutschland

    T. Bitter, O. Oldenburg & D. Horstkotte

  2. Klinik für Pneumologie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Deutschland

    T. Bitter

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  1. T. Bitter
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Correspondence to T. Bitter.

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Bitter, T., Oldenburg, O. & Horstkotte, D. Schlafbezogene Atmungsstörungen und kardiale Arrhythmien. Somnologie 18, 9–12 (2014). https://doi.org/10.1007/s11818-013-0655-4

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  • DOI: https://doi.org/10.1007/s11818-013-0655-4

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