Relationship between Pulse Oxygen Desaturation Rate and Heart Rate Fluctuation Rate and Arrhythmias in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

Abstract

Background Arrhythmias are common complications in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) , however their occurrence and severity are not completely consistent with the severity of their disease per se. Our previous study found that pulse oxygen desaturation rate (ODR) was an independent predictor of the development of hypertension in OSAHS patients. We hypothesized that sleep apnea related ODR and heart rate fluctuation rate (HRFR) may predict the occurrence of arrhythmias in OSAHS patients. Objective To observe the correlation between ODR, HRFR and the occurrence of arrhythmias, and to explore the predictive value of ORD and HRFR on the occurrence of arrhythmias. Methods Polysomnography and Holter monitoring were performed on 36 patients who visited the sleep disordered breathing specialized outpatient clinic of the First Affiliated Hospital of Nanjing Medical University between January and June 2021, while basic clinical information of the patients was collected. Taking the median number of arrhythmic events as the cutoff value, the patients were divided into two groups: the patients with low incidence of arrhythmia group (<105 events) and with high incidence of arrhythmias group (≥105 events) . ODR and HRFR were analyzed for correlation with arrhythmias and Logistic regression was performed for analysing the predictors of arrhythmia. Results Compared with low incidence of arrhythmia group, the patients with high incidence of arrhythmias had higher ODR and HRFR (P<0.05) . Correlation analysis showed that the number of total arrhythmic events was positively correlated with ODR, mean heart rate fluctuation value, and HRFR (rs=0.472, 0.719, 0.360, and 0.393, respectively, P<0.05) . Multivariate Logistic regression analysis showed that ODR〔OR=77.849, 95%CI (5.250, 1 154.301) , P<0.05〕and HRFR 〔OR=9.981, 95%CI (1.000, 105.600) , P=0.05〕were independent risk factors for arrhythmic events. The area under the receiver operator characteristic (AUC) of ODR and HRFR for predicting multiple arrhythmias were 0.932 〔95%CI (0.830, 0.941) 〕 and 0.753 〔95%CI (0.590, 0.916) , respectively. Conclusion ODR and HRFR are associated with the occurrence of arrhythmias and can be used for predicting the occurrence of arrhythmic events in patients with OSAHS.

Keywords

• sleep apnea, obstructive|cardiac dysrhythmia|oxygen desaturation rate|heart rate fluctuation rate|root cause analysis|forecasting