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Diagnosis and treatment of obstructive sleep apnoea in patients with pauses in Holter ECG monitoring: case series
, 2, 3, 2, 4, 5, 6
Affiliations- Department of Diagnostic Medicine, John Paul II Hospital, Krakow, Poland
- Students’ Scientific Association at Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
- Department of Neurology, Medical University of Lublin, Lublin, Poland
- 5th Military Clinical Hospital in Krakow, Krakow, Poland
- Collegium Medicum of Jagiellonian University, Krakow, Poland
- Brothers Hospitallers of Saint John of God Hospital in Krakow, Krakow, Poland
open access
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.
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 apnoea, bradyarrhythmia, CPAP, nocturnal pauses, pacemaker implantation
About this articleTitle
Diagnosis and treatment of obstructive sleep apnoea in patients with pauses in Holter ECG monitoring: case series
Journal
Issue
Article type
Case report
Published online
2023-10-13
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204
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187
DOI
Keywords
obstructive sleep apnoea
bradyarrhythmia
CPAP
nocturnal pauses
pacemaker implantation
Authors
Piotr Pawłucki
Łukasz Domagalski
Michał Sekuła
Natalia Kaleta
Anna Maciak
Katarzyna Kopeć
Paulina Cuper
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