阻塞性睡眠呼吸暂停低通气综合征与心律失常的相关性

The Relationship Between Obstructive Sleep Apnea Hypopnea Syndrome and Arrhythmia

阻塞性睡眠呼吸暂停低通气综合征与心律失常关系密切,间歇性低氧和高碳酸血症、氧化应激和慢性炎症反应、交感迷走神经失衡、胸腔内压力改变、神经体液因子的激活等都是阻塞性睡眠呼吸暂停低通气综合征患者发生心律失常的可能病生理机制。阻塞性睡眠呼吸暂停低通气综合征与缓慢性心律失常、心房颤动、室性心律失常甚至心源性猝死密切相关,且能降低心律失常药物、电复律和射频导管消融等治疗的成功率,增加心房颤动复发的风险,而持续气道正压通气可以使阻塞性睡眠呼吸暂停低通气综合征患者的心律失常得到改善。

Obstructive sleep apnea hypopnea syndrome（OSAHS）is closely related to arrhythmia.Intermittent hypoxemia and hypercapnia,oxidative stress and chronic inflammation,sympathetic vagus imbalance,intrathoracic pressure change,and neurohumoral factors are all possible pathogenesis of arrhythmia in OSAHS patients.Bradyarrhythmia,atrial fibrillation,ventricular arrhythmia and even sudden cardiac death are closely related to OSAHS,which can reduce the success rate of anti-arrhythmic drugs,electrical cardioversion and atrial fibrillation catheter ablation,as well as increase the rate of recurrence of atrial fibrillation.This review discusses how continuous positive airway pressure can improve the arrhythmia in OSAHS patients.