OBJECTIVE

To analyze the structure and prevalence, as well as risk factors of premature ventricular contractions in patients with obstructive sleep apnea syndrome (OSAS) and arterial hypertension (AH).

MATERIAL AND METHODS

The study included males with overweight and body mass index >25 kg/m² (mean 28.7±11.4 kg/m²) aged 40-79 years (mean 60.9±10.1 years) who admitted for AH. Exclusion criteria were coronary artery disease, intake of antiarrhythmic drugs class I, III and IV, chronic heart failure NYHA class II-IV, chronic kidney disease stage ≥3A, previous stroke or refusal to participate in the study, as well as any acute disorders of physical or mental status.

RESULTS

Single premature ventricular contractions (rare and frequent) were detected in all patients with AH and OSAS. At the same time, single ventricular extrasystoles over 500 daily (n=9), as well as premature ventricular complexes (couplets (n=6) and triplets (n=4)) were detected in 15 (55.6%) out of 27 patients. There were no life-threatening paroxysmal heart rhythm disorders in patients with hypertension. Ventricular couplets and triplets were detected in 22.2% and 14.8% of patients, respectively. All patients with significant ventricular arrhythmias at night (>500 single ventricular extrasystoles per day with significant predominance at night, ventricular couplets and triplets at night) were combined into one group of patients with AH, OSAS and ventricular arrhythmias (n=15). Other ones were included into the group of patients with AH and OSAS without significant ventricular arrhythmias. Rare premature ventricular contractions in these patients occurred during the waking period.

CONCLUSION

According to our data, life-threatening ventricular arrhythmias are rare in patients with obstructive sleep apnea syndrome and arterial hypertension regardless OSAS severity. Probably, these arrhythmias can be expected in patients with severe OSAS and another comorbidity associated with electrical instability of ventricular myocardium.