P-wave duration and dispersion in Holter electrocardiography of patients with obstructive sleep apnea

• Published in: Sleep medicine 2013-12, Vol.14, p.e136-e136
• Main Authors: Jazi, M. Hashemi, Amra, B, Yazdchi, M, Jahangiri, M, Tabesh, F, Gholamrezaei, A
• Format: Article
• Language: English
• Subjects: Neurology; Sleep Medicine
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2013.11.307

Introduction There is an association between obstructive sleep apnea (OSA) and atrial fibrillation (AF) with remained unclear underlying mechanisms. We investigated P-wave parameters as indicators of atrial conduction status among OSA patients. Materials and methods This cross-sectional study was conducted on 42 untreated OSA patients diagnosed using polysomnography and categorized to mild (6), moderate (18), and severe (18) OSA based on the apnea/hypopnea index (AHI). The control group consisted of 18 healthy subjects without any sleep or cardiac complaints. We applied 24-h Holter electrocardiography for measurement of P-wave parameters including duration and dispersion. Results No significant difference was observed among the groups in P-wave duration ( P = 0.281). P-wave dispersion and P max were significantly longer in those with moderate ( P = 0.002 and 0.014, respectively) and those with severe OSA ( P = 0.001 and 0.003, respectively) than controls. No correlation was found between age, gender, and BMI with P-wave parameters. AHI was significantly correlated with the P max ( r = 0.407, P = 0.012) and P-wave dispersion ( r = 0.431, P = 0.008). With linear regression analysis controlling for age, gender, and BMI, the AHI was independently associated with P-wave dispersion (â = 0.482, P = 0.002). Conclusion The severity of OSA is associated with prolonged P max and P-wave dispersion, indicating that patients with severe OSA have more severe disturbance in atrial conduction. This is the first study which has used Holter monitoring for measurement of P-wave parameters and repeating this study in a larger sample of patients is warranted. Acknowledgements This study is supported by the Isfahan University of Medical Sciences. We are thankful to Reihaneh Sadat Daneshmand who participated in designing the Holter monitoring software, and also we are thankful to Foroogh Hesabi, head of department of Holter monitoring of Noor Hospital (Isfahan).