Title Sleep related bradyarrhythmic events and heart rate variability in apparently healthy individuals.
Author Cimen, Tolga; Sunman, Hamza; Erat, Mehmet; Efe, Tolga Han; Akyel, Ahmet; Bilgin, Murat; Acikel, Sadik; Dogan, Mehmet; Yeter, Ekrem
Journal Anatol J Cardiol Publication Year/Month 2017-Mar
PMID 27849189 PMCID PMC5864985
Affiliation + expend 1.Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital; Ankara-Turkey. drtolgacim@hotmail.com.

OBJECTIVE: It is thought that abnormal cardiac impulses of the autonomic nervous system during sleep are responsible for sleep-related bradyarrhythmias. Despite a proposed common etiopathogenesis and having common name of "sleep-related bradyarrhythmias," precise importance of sinoatrial or atrioventricular (AV) node involvement remains elusive. This study aimed to determine whether there is a difference in sleeprelated bradyarrhythmias from the point of view of heart rate variability (HRV). METHODS: Patients were evaluated using 24-hour Holter electrocardiogram monitor. After careful medical evaluation, apparently healthy individuals with sleep-related sinus pauses >/=2 seconds on at least 1 occasion or those in whom Mobitz type I AV block occurred were included. Frequency and time domain analyses were conducted for daytime, nighttime, and 24-hour period. RESULTS: Total of 37 patients with sinus pause(s), 40 patients with Mobitz type I AV block(s), and 40 healthy controls were included. On HRV analyses, all time and frequency domain parameters were better in sinus pause group for daytime, nighttime, and 24-hour average (p<0.05 for all). Results of heart rate-corrected HRV analyses still showed significantly better total power (TP) and very low frequency (VLF) in the sinus pause group compared with AV block group (TP: 7.1x10-3 vs. 5.4x10-3, p=0.011; VLF: 4.9x10-3 vs. 3.7x10-3, p=0.007). CONCLUSION: Despite proposed common autonomic mechanisms, sleep-related sinus pause cases demonstrated better HRV profile in comparison with Mobitz type I AV block.

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