Interactions of Sleep Apnea, the Autonomic Nervous System, and Its Impact on Cardiac Arrhythmias
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Purpose of Review
Sleep-disordered breathing (SDB) is an independent risk factor for cardiovascular disease. SDB-related changes in the autonomic nervous system (ANS) and the association between obstructive sleep apnea and atrial fibrillation (Afib) have been extensively researched. SDB has also been associated with occurrence of ventricular arrhythmias. We evaluated the effects of SDB on the ANS and its relationship with ventricular and supraventricular arrhythmias.
The ANS is an important regulator of the cardiovascular system and contributes to the development of cardiovascular diseases including hypertension and coronary artery disease. SDB has an important influence on the ANS and contributes to electromechanical remodeling of the left atrium via a number of mechanisms, increasing susceptibility to Afib. There is evidence that these mechanisms also affect the ventricular myocardium and therefore lead to ventricular arrhythmias. Effective treatment of SDB reduces the rate of Afib recurrence and seems to reduce ventricular arrhythmogenicity.
SDB has an important impact on the ANS and therefore plays a major role in the development of cardiac arrhythmias. Although SDB screening of patients with Afib is recommended by current guidelines, SDB remains underdiagnosed. Additional research is needed to clarify the role of SDB and its treatment in ventricular arrhythmias.
KeywordsSleep-disordered breathing Ventricular arrhythmias Supraventricular arrhythmias Atrial fibrillation Autonomic function
Compliance with Ethical Standards
Conflict of Interest
Fabian Roder, Johanna Strotmann, Henrik Fox, Thomas Bitter, Dieter Horstkotte, and Olaf Oldenburg declare no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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