Adherence and efficacy of long-term PAP therapy in patients with sleep-related breathing disorders associated with cardiac conduction disorders

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Abstract

Aim. To study the effectiveness of prolonged use of PAP therapy (positive airway pressure therapy) in eliminating sleep respiratory disorders and associated cardiac conduction disturbances.

Materials and methods. We included 21 patients who were examined at the Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology, regarding cardiac rhythm and conduction disturbances, as well as obstructive sleep apnea and who have been on PAP therapy for more than 12 months. The average age was 66.5 [63.5; 73.2] years, body mass index – 33.0 [30.2; 38.5] kg/m2, apnea-hypopnea index – 65.0 [59.0; 86.3]/h. At the time of analysis, 15 patients continued to use PAP therapy (mean time of use: 6.0 years [4.7; 9.2]) and 6 patients refused long-term use of PAP therapy, mean time to use PAP therapy until failure amounted to 2.8±2.1 years.

Results. PAP therapy lead to a persistent decrease in apnea-hypopnea index of 63.6/h to 3.7/h was (p=0.0002). 86% of patients met the criteria for adherence to PAP therapy (use >4 hours/night, more than 70% of nights). Initially, before the use of PAP therapy, all cardiac conduction disorders were during sleep and exceeded 3 seconds, with fluctuations from 3.1 to 10.6 seconds. PAP therapy appeared to be effective in all patients: no asystoles, duration of more than 3 seconds, were detected.

Conclusion. In obstructive sleep apnea patients with concomitant nighttime cardiac conduction disturbances, the long-term use of PAP therapy is effective and with good adherence.

About the authors

E. M. Elfimova

Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology

Email: alelitvin@yandex.ru
ORCID iD: 0000-0002-3140-5030

к.м.н., науч. сотр. лаб. апноэ сна отд. гипертонии ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

O. O. Mikhailova

Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology

Email: alelitvin@yandex.ru
ORCID iD: 0000-0002-3609-2504

к.м.н., мл. науч. сотр. лаб. апноэ сна отд. гипертонии ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

N. T. Khachatryan

Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology

Email: alelitvin@yandex.ru
ORCID iD: 0000-0002-0945-9665

аспирант отд. гипертонии ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

A. Y. Litvin

Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology; Pirogov Russian National Research Medical University

Author for correspondence.
Email: alelitvin@yandex.ru
ORCID iD: 0000-0001-5918-9969

д.м.н., рук. лаб. апноэ сна, гл. науч. сотр. отд. гипертонии ИКК им. А.Л. Мясникова, проф. отд. высшего и дополнительного профессионального образования ФГБУ «НМИЦ кардиологии», проф. каф. поликлинической терапии лечебного фак-та ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»

Russian Federation, Moscow

I. E. Chazova

Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology

Email: alelitvin@yandex.ru
ORCID iD: 0000-0002-9822-4357

акад. РАН, д.м.н., проф., зам. ген. дир. по научно-экспертной работе ФГБУ «НМИЦ кардиологии», рук. отд. гипертонии ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

L. Y. Laiovich

Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology

Email: alelitvin@yandex.ru
ORCID iD: 0000-0002-3102-1686

к.м.н., науч. сотр. отд. клинической электрофизиологии и рентгенохирургических методов лечения нарушений ритма сердца ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

T. A. Malkina

Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology

Email: alelitvin@yandex.ru
ORCID iD: 0000-0003-4773-8080

к.м.н., науч. сотр. отд. клинической электрофизиологии и рентгенохирургических методов лечения нарушений ритма сердца ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

A. V. Pevzner

Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology

Email: alelitvin@yandex.ru
ORCID iD: 0000-0002-1765-628X

д.м.н., рук. лаб. интервенционных методов диагностики и лечения нарушений ритма, проводимости сердца и синкопальных состояний ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

S. P. Golitsyn

Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology

Email: alelitvin@yandex.ru
ORCID iD: 0000-0001-9913-9974

д.м.н., проф., рук. отд. клинической электрофизиологии и рентгенохирургических методов лечения нарушений ритма сердца ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

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