The importance of sleep apnea index determination using 24 h ECG analysis in patients with heart rhythm disorders

Aleksandra Grdinić; Zoran Stajić; Aleksandar G. Grdinić; Žarko Vučinić; Violeta Randjelović Krstić; Dragan Drobnjak; Predrag Bogdanović; Predrag Djurić; Angelina Stevanović; Milanko Rakonjac; Stanko Petrović; Ognjen Gudelj; Radomir Matunović

doi:10.2298/3971

Aleksandra Grdinić Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Zoran Stajić Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Aleksandar G. Grdinić Clinical Center of Montenegro, Podgorica, Montenegro
Žarko Vučinić Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Violeta Randjelović Krstić Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia
Dragan Drobnjak Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia
Predrag Bogdanović Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia
Predrag Djurić Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Angelina Stevanović Institute of Occupational Health of Serbian Railways; Belgrade, Serbia
Milanko Rakonjac Institute of Aviation Medicine, , Military Medical Academy, Belgrade, Serbia
Stanko Petrović Clinic of Gastroenterology, Military Medical Academy, Belgrade, Serbia
Ognjen Gudelj Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia
Radomir Matunović Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia

DOI: https://doi.org/10.2298/3971

Keywords: sleep apnea syndromes, arrhythmias, cardiac, electrocardiography, ambulatory,

Abstract

Background/Aim. A possible cause of malignant heart rhythm disorders is the syndrome of sleep apnea (periodic cessation of breathing during sleep longer than 10 seconds). Recent 24h ECG software systems have the option of determination ECG apnea index (AI) based on the change in voltage of QRS complexes. The aim of the study was to determine the significance of AI evaluation in routine 24-hour Holter ECG on a group of 12 patients. Methods. We presented a total of 12 consecutive patients with previously documented arrhythmias and the history of breathing disorders during night. They were analyzed by 24 h ECG (Medilog AR 12 plus Darwin), that is able to determine AI. Results. We presented a case series of 12 patients, 8 men and 4 women, mean age 58.75 years and the average AI 5.78. In the whole group there was a trend of increasing prevalence of complex rhythm disorders with increasing of AI and increased frequency of arrhythmias in the night phase vs day phase. Conclusion. Determination of AI using routine long term (24 h) ECG analysis is important because sleep apnea can be successfully treated as an etiological or contributing factor of arrhythmias.

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