Sleep-disordered breathing in patients with the Brugada syndrome

Paula G. MacEdo, Josep Brugada, Pavel Leinveber, Begoña Benito, Irma Molina, Fatima Sert-Kuniyoshi, Taro Adachi, Jan Bukartyk, Christelle Van Der Walt, Tomas Konecny, Shantal Maharaj, Tomas Kara, Josep Montserrat, Virend Somers

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

We investigated breathing patterns and the occurrence of arrhythmias and ST-segment changes during sleep in patients with Brugada syndrome. Patients with Brugada syndrome are more likely to die from ventricular arrhythmias during sleep. ST-segment changes have been correlated with risk of sudden cardiac death. Whether sleep disturbances may contribute to arrhythmogenesis is unknown. Patients with Brugada syndrome underwent overnight polysomnography with simultaneous 12-lead electrocardiographic recording. A control group matched by age, gender, and body mass index (BMI) also underwent polysomnography. Twenty patients were included (50 ± 15 years old, 75% men). Despite their normal BMI (24.7 ± 2.7 kg/m2), 45% had sleep-disordered breathing (SDB), with a mean apnea-hypopnea index of 17.2 ± 14 events/hour. In patients with a high risk of arrhythmias, 5 (63%) had SDB. In the control group, 27% had SDB. Atrial or ventricular arrhythmias were not observed. Spontaneous ST-segment changes occurred in 2 patients over 45 different time points. Most ST-segment changes were observed during rapid eye movement sleep (31%) or within 1 minute of arousals (44%). Regarding respiratory events, 25 (56%) of ST-segment changes were related to occurrence of apnea or hypopnea. In conclusion, patients with Brugada syndrome have a high prevalence of SDB even in the setting of normal BMI. The higher incidence of nocturnal death in patients with Brugada syndrome may be conceivably related to co-morbid SDB. Moreover, autonomic instability encountered in rapid eye movement sleep and arousals could potentiate the risk of arrhythmias.

Original languageEnglish (US)
Pages (from-to)709-713
Number of pages5
JournalAmerican Journal of Cardiology
Volume107
Issue number5
DOIs
StatePublished - Mar 1 2011

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    MacEdo, P. G., Brugada, J., Leinveber, P., Benito, B., Molina, I., Sert-Kuniyoshi, F., Adachi, T., Bukartyk, J., Van Der Walt, C., Konecny, T., Maharaj, S., Kara, T., Montserrat, J., & Somers, V. (2011). Sleep-disordered breathing in patients with the Brugada syndrome. American Journal of Cardiology, 107(5), 709-713. https://doi.org/10.1016/j.amjcard.2010.10.046