Diagnosis and treatment of obstructive sleep apnoea in patients with pauses in Holter ECG monitoring: case series
, 2, 3, 2, 4, 5, 6
Abstract
Obstructive sleep apnoea (OSA) is a common disease in today’s society and may affect even more of the
population in the near future. Ailments and complications of OSA result from a decrease in the muscle
tone of the soft palate, which causes shallow breathing or complete apnoea. The consequences of such
episodes may be the development of arterial hypertension, the occurrence of cardiac arrhythmias, and
also the deterioration of the quality of life. Diagnosis is based on polysomnography in people with suspected
OSA. Continuous Positive Airway Pressure (CPAP) therapy is the most effective treatment for OSA.
A case series is presented in which patients with OSA risk factors and nocturnal pauses in Holter ECG
monitoring (HEM) were diagnosed due to suspected OSA. In the polysomnographic test, severe OSA
was diagnosed and CPAP therapy was introduced. Follow-up HEM performed during treatment showed
complete resolution or significant reduction in the number and length of nocturnal pauses. Based on the
case series, current medical knowledge and guidelines for pacemaker implantation, it was concluded that
in the event of pauses in the HEM, the diagnosis of OSA should be considered in each patient, especially
if the pauses occur predominantly at night and the patient is at high risk of OSA. Such a procedure may
protect the patient from serious complications related to the pacemaker implantation. It should be emphasized,
however, that CPAP therapy requires close cooperation of the patient because it brings effects
only when it is used for each sleep.
Keywords: obstructive sleep apnoeabradyarrhythmiaCPAPnocturnal pausespacemaker implantation
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