Simulated Obstructive Sleep Apnea Increases P-Wave Duration and P-Wave Dispersion

• Published in: PloS one Vol. 11; no. 4; p. e0152994
• Main Authors: Gaisl, Thomas, Wons, Annette M., Rossi, Valentina, Bratton, Daniel J., Schlatzer, Christian, Schwarz, Esther I., Camen, Giovanni, Kohler, Malcolm
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 12.04.2016; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Aged; Analysis; Apnea; Atrial fibrillation; Atrial Fibrillation - etiology; Atrial Fibrillation - physiopathology; Biology and Life Sciences; Breathing; Cardiac arrhythmia; Case-Control Studies; Complications and side effects; Conduction; Diagnosis; EKG; Electrocardiography; Electrocardiography - statistics & numerical data; Female; Fibrillation; Heart rate; Heart Rate - physiology; Humans; Male; Medicine and Health Sciences; Middle Aged; Models, Biological; Patients; Physiology; Platelet-activating factor; Pressure; Research and Analysis Methods; Risk Factors; Simulation; Sleep; Sleep apnea; Sleep Apnea, Central - physiopathology; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - physiopathology; Sleep disorders; Studies; Trigger factor; Wave dispersion; Young Adult; Switzerland
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0152994

A high P-wave duration and dispersion (Pd) have been reported to be a prognostic factor for the occurrence of paroxysmal atrial fibrillation (PAF), a condition linked to obstructive sleep apnea (OSA). We tested the hypothesis of whether a short-term increase of P-wave duration and Pd can be induced by respiratory manoeuvres simulating OSA in healthy subjects and in patients with PAF. 12-lead-electrocardiography (ECG) was recorded continuously in 24 healthy subjects and 33 patients with PAF, while simulating obstructive apnea (Mueller manoeuvre, MM), obstructive hypopnea (inspiration through a threshold load, ITH), central apnea (AP), and during normal breathing (BL) in randomized order. The P-wave duration and Pd was calculated by using dedicated software for ECG-analysis. P-wave duration and Pd significantly increased during MM and ITH compared to BL in all subjects (+13.1 ms and +13.8 ms during MM; +11.7 ms and +12.9 ms during ITH; p<0.001 for all comparisons). In MM, the increase was larger in healthy subjects when compared to patients with PAF (p<0.05). Intrathoracic pressure swings through simulated obstructive sleep apnea increase P-wave duration and Pd in healthy subjects and in patients with PAF. Our findings imply that intrathoracic pressure swings prolong the intra-atrial and inter-atrial conduction time and therefore may represent an independent trigger factor for the development for PAF.