The effects of continuous positive airway pressure therapy withdrawal on cardiac repolarization: data from a randomized controlled trial

Rossi, V. A.; Stoewhas, A.-C.; Camen, G.; Steffel, J.; Bloch, K. E.; Stradling, J. R.; Kohler, M.

doi:10.1093/eurheartj/ehs073

Cited by 73Obstructive Sleep Apnea ResearchCardiac electrophysiology and arrhythmiasSleep and related disorders

The effects of continuous positive airway pressure therapy withdrawal on cardiac repolarization: data from a randomized controlled trial

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Rossi, V. A., Stoewhas, A.-C., Camen, G., Steffel, J., Bloch, K. E., Stradling, J. R., Kohler, M.·2012·European Heart Journal

DOI 10.1093/eurheartj/ehs073

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Abstract

AIMS: The preliminary evidence supports an association between obstructive sleep apnoea (OSA), disturbed cardiac repolarization, and consequent cardiac dysrhythmias. The aim of the current trial was to assess the effects of continuous positive airway pressure (CPAP) therapy withdrawal on the measures of cardiac repolarization in patients with OSA. METHODS AND RESULTS: Forty-one OSA patients established on CPAP treatment were randomized to either CPAP withdrawal (subtherapeutic CPAP) or continue therapeutic CPAP for 2 weeks. Polysomnography was performed, and indices of cardiac repolarization (QT(c), TpTe(c) intervals) and dispersion of repolarization (TpTe/QT ratio) were derived from 12-lead electrocardiography (ECG) at baseline and 2 weeks. Continuous positive airway pressure withdrawal led to a recurrence of OSA. Compared with therapeutic CPAP, subtherapeutic CPAP for 2 weeks was associated with a significant increase in the length of the QT(c) and TpTe(c) intervals (mean difference between groups 21.4 ms, 95% CI 11.3-1.6 ms, P < 0.001 and 14.4 ms, 95% CI 7.2-21.5 ms, P < 0.001, respectively) and in the TpTe/QT ratio (mean difference between groups 0.02, 95% CI 0.00-0.03, P = 0.020). There was a statistically significant correlation between the change in apnoea/hypopnoea index (AHI) from baseline, and both the change in the QT(c) interval and the TpTe(c) interval (r = 0.60, 95% CI 0.36-0.77, P < 0.001 and r = 0.45, 95% CI 0.17-0.67, P = 0.003, n = 41, respectively). CONCLUSION: Continuous positive airway pressure withdrawal is associated with the prolongation of the QT(c) and TpTe(c) intervals and TpTe/QT ratio, which may provide a possible mechanistic link between OSA, cardiac dysrhythmias, and thus sudden cardiac death.

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Effect of continuous positive airway pressure therapy on circadian patterns of cardiac repolarization in patients with obstructive sleep apnoea: data from a randomized trial
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Arrhythmia/cardiomyopathy
Rossi, V. A., Stoewhas, A.-C., Camen, G., Steffel, J., Bloch, K. E., Stradling, J. R., & Kohler, M. (2016)
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Authors: Rossi, V. A., Stoewhas, A.-C., Camen, G., Steffel, J., Bloch, K. E., Stradling, J. R., & Kohler, M.
Affiliations: University Hospital Zurich (CH)
University of Zurich (CH)
Churchill Hospital (GB)
Corresponding author: Kohler, M.
ORCID: Rossi, V. A.
Camen, G.
Steffel, J.
Bloch, K. E.
Stradling, J. R.
Venue: European Heart Journal
Publisher: Oxford University Press (OUP)
Published: 2012-03-27
Volume: 33
Issue: 17
Pages: 2206-2212
ISSN: 0195-668X (ISSN-L)
1522-9645
DOI: 10.1093/eurheartj/ehs073
OpenAlex: W2127261816
Cited by: 73
References: 52
Citations by year: 2026: 2 · 2025: 5 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 4 · 2020: 6 · 2019: 3 · 2018: 6 · 2017: 5 · 2016: 10 · 2015: 4 · 2014: 8 · 2013: 5 · 2012: 3
FWCI: 4.29
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: European Heart Journal (publishedVersion)
PubMed (publishedVersion)
Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
Zurich Open Repository and Archive (University of Zurich)
Topics: Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords: obstructive sleep apnea, CPAP withdrawal, continuous positive airway pressure, cardiac repolarization, QT interval, Tp-e interval, dispersion of repolarization, cardiac arrhythmias, sudden cardiac death, apnea-hypopnea index
MeSH terms: Arrhythmias, Cardiac, Electrocardiography, Female, Heart Conduction System, Humans, Male, Middle Aged, Ventilator Weaning, Death, Sudden, Cardiac, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure

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The effects of continuous positive airway pressure therapy withdrawal on cardiac repolarization: data from a randomized controlled trial

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