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Patients with obstructive sleep apnea syndrome after coronary artery bypass grafting with paroxysms of atrial fibrillation in postoperative period: the first results of study

Authors: Skvortsova R.D. 1, Kazachenko A.A. 1,2, 2, Kulikov A.N. 1,2, 2, Khubulava G.G. 1,2, 2, Kuchmin A.N. 1, Potapov E.A. 1, 3

Company: 1 Kirov Military Medical Academy of Ministry of Defense of the Russian Federation, ulitsa Akademika Lebedeva, 6, Saint-Petersburg, 194044, Russian Federation
2 Pavlov First Saint Petersburg State Medical University, ulitsa L’va Tolstogo, 6-8, Saint-Petersburg, 197022, Russian Federation
3 1472 Military-Navy Clinical Hospital of Ministry of Defense of the Russian Federation, ulitsa Gospital’nyy spusk, 1, Sevastopol, 299001, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2018-12-2-120-129

For citation: Skvortsova R.D., Kazachenko A.A., Kulikov A.N., Khubulava G.G., Kuchmin A.N., Potapov E.A. Patients with obstructive sleep apnea syndrome after coronary artery bypass grafting with paroxysms of atrial fibrilla- tion in postoperative period: the first results of study. Creative Cardiology. 2018; 12 (2): 120–9 (in Russ.). DOI: 10.24022/1997-3187-2018-12-2-120-129

Received / Accepted:  April 27, 2018 / May 11, 2018

Keywords: obstructive sleep apnea syndrome atrial fibrillation coronary artery bypass grafting ischemic heart disease cardiac surgery

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Abstract

Objective. The obstructive sleep apnea syndrome (OSA) is a risk factor for the development of atrial fibrillation (AF). In turn, AF is the most frequent postoperative complication of coronary artery bypass grafting (CABG). We conducted a study of the possible relationship between OSA and postoperative paroxysms of AF, and the frequency of the complication development in patients with OSA who undergo CABG.

Material and methods. A 32 candidates scheduled for a CABG was routinely evaluated for age, gender, body mass index (BMI), clinical examination, 24-hour cardio-respiratory monitoring (CRM), blood tests and medications. In the postoperative period, bedside monitoring was performed about real paroxysms of AF, extubation time was evaluated, repeated CRM was performed on the third day.

Results. Patients are divided into two groups: group 1 (OSA-0) – 17 patients with apnea/hypnopnea index (AHI) less than 15 per hour, group 2 (OSA-1) – 15 patients with AHI more than 15 per hour. In all patients with initial respiratory disturbances in sleep, an increase in AHI after surgery was observed. Paroxysms of atrial fibrillation appeared in 11 patients: one patient from OSA-0 group and ten patients from OSA-1 group (p<0,05).

Conclusion. In patients with cardiac ischemia high prevalence of OSA is was observed. Its severity is significantly increased in the postoperative period, and the development of postoperative AF in patients after CABG is more common in patients with heavier OSA.

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About Authors

  • Ruf' D. Skvortsova, Functional Diagnostics Physician, Cardiologist of the Pavlov FSPSMU, orcid.org/0000-0002-9523-2749

  • Aleksandr A. Kazachenko, Cand. Med. Sc., Assistant Professor of Propaedeutics of Internal Medicine, Head of the Functional Diagnostics Department at the Kirov MMA, Functional Diagnostics Physician of the Pavlov FSPSMU, orcid.org/0000-0002-4578-7893

  • Aleksandr N. Kulikov, Dr Med. Sc., Professor, Head of the Department of Clinical Physiology and Functional Diagnostics of the Pavlov FSPSMU, Professor of the Department Propaedeutics of Internal Medicine at the Kirov MMA, orcid.org/0000-0002-4544-2967

  • Gennadiy G. Khubulava, Corresponding Member of Russian Academy of Sciences, Chief Cardiac Surgeon of the North-West Federal District of the Russian Federation, Dr Med. Sc., Professor, Chief of Kupriyanov 1st Chair Surgery of the Improvement of Doctors of the Kirov MMA, Chief of the Chair of Faculty Surgery of the Pavlov FSPSMU, orcid.org/0000-0002-9242-9941

  • Aleksandr N. Kuchmin, Dr Med. Sc., Professor, Chief of Chair, orcid.org/0000-0003-2888-9625

  • Egor A. Potapov, Captain of the Medical Service, Chief of the Naval Group of Special Care Medical Unit 1472 VMKG, orcid.org/0000-0003-4897-7040

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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