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P wave duration and dispersion in Holter electrocardiography of patients with obstructive sleep apnea

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Abstract

Purpose

The underlying mechanisms of the association between obstructive sleep apnea (OSA) and atrial fibrillation (AF) remained unclear. We investigated P wave parameters as indicators of atrial conduction status among OSA patients.

Methods

We studied 42 untreated OSA patients, categorized into mild (6), moderate (18), and severe (18) OSA based on the apnea/hypopnea index (AHI) and 18 healthy controls. Twenty-four-hour Holter electrocardiography was applied to measure P wave parameters including P wave duration and P wave dispersion; difference between the maximum (P-max) and minimum (P-min) measured P wave duration.

Results

Mean P wave duration ranged from 110.2 ± 9.3 ms in mild OSA patients to 121.1 ± 15.4 ms in severe OSA patients and was 113.4 ± 10.0 ms in controls with no significant difference among the groups, P = 0.281. P wave dispersion and P-max were significantly longer in those with moderate OSA (68.0 ± 9.3 and 154.2 ± 9.3 ms) and those with severe OSA (71.6 ± 13.7 and 157.2 ± 13.3 ms) than controls (52.6 ± 15.3 and 142.1 ± 15.4 ms), P < 0.05. AHI was significantly correlated with P-max (r = 0.407, P = 0.012) and P wave dispersion (r = 0.431, P = 0.008). With linear regression analysis controlling for age, gender, and BMI, the AHI was independently associated with P wave dispersion (β = 0.482, P = 0.002).

Conclusions

Using Holter monitoring for measurement of P wave parameters, this study showed an association of OSA with prolonged P-max and P wave dispersion. These results indicate that patients with OSA have disturbances in atrial conduction associated with OSA severity. Repeating this study in a larger sample of patients is warranted.

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Acknowledgments

This study is supported by the Isfahan University of Medical Sciences. We are thankful to Reihaneh Sadat Daneshmand who participated in designing the Holter monitoring software, and also, we are thankful to Foroogh Hesabi, head of department of Holter monitoring of Noor Hospital (Isfahan, Iran).

Funding/support

The authors’ work is supported by the Isfahan University of Medical Sciences. The funders had no role in the preparation, review, or approval of this manuscript.

Conflict of interest

The authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Hezar Jarib Street, Isfahan, Iran

    Mohammad Hashemi Jazi, Mansour Jahangiri & Faezeh Tabesh

  2. Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Babak Amra

  3. Department of Biomedical Engineering, Isfahan University of Medical Sciences, Isfahan, Iran

    Mohammad Reza Yazdchi

  4. Poursina Hakim Research Institution, Isfahan, Iran

    Ali Gholamrezaei

Authors
  1. Mohammad Hashemi Jazi
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  2. Babak Amra
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  3. Mohammad Reza Yazdchi
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  4. Mansour Jahangiri
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  5. Faezeh Tabesh
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Corresponding author

Correspondence to Mansour Jahangiri.

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Jazi, M.H., Amra, B., Yazdchi, M.R. et al. P wave duration and dispersion in Holter electrocardiography of patients with obstructive sleep apnea. Sleep Breath 18, 549–554 (2014). https://doi.org/10.1007/s11325-013-0917-1

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  • DOI: https://doi.org/10.1007/s11325-013-0917-1

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