TY - T1的心律失常和传导disturbances in obstructive sleep apnoea: the heart of the problem? JF - European Respiratory Journal JO - Eur Respir J SP - 1244 LP - 1246 DO - 10.1183/09031936.00030813 VL - 41 IS - 6 AU - Roche, Frédéric Y1 - 2013/06/01 UR - //www.qdcxjkg.com/content/41/6/1244.abstract N2 - Heart rhythm disorders temporally associated with obstructive apnoeic events have been highlighted for more than 30 years. An ECG from polysomnographic recordings enables both sleep medicine specialists and cardiologists to address occasional very impressive paroxysmal atrioventricular conduction blocks or sinus pauses (of up to 10 s during rapid eye movement (REM) sleep) [1]. The pathophysiology of these disorders induced by respiratory events is obviously complex and represents an exciting challenge in the context of integrative human physiology. The role of acute and chronic imbalances in the autonomic nervous system (ANS) associated with obstructive sleep apnoeas or hypopnoeas (OSA) has been clearly demonstrated in many cellular mechanisms of myocardial adaptation to such repeated stresses [2–4]. In addition, these autonomic disorders are now recognised as independent risk factors or triggers of sudden cardiac death not only in heart failure patients [5] but also in people with preserved systolic/diastolic left ventricular function [6, 7]. Although sleep is normally a time when the parasympathetic modulation of the heart predominates and myocardial electrical stability is enhanced, OSA disturbs this quiescence, creating an autonomic profile in which both profound vagal activity leading to bradycardia and sympathetic overactivity favouring ventricular ectopy are commonly observed [8].The authors of a review paper published in the current issue of the European Respiratory Journal [9] must be congratulated for successfully detailing of the mechanisms present during apnoea/hypopnoea that can lead to heart rhythm disturbances. This paper is, for me, a remarkable teaching tool that I will use again in the future due to its clarity and its “updated” literature review.In a second part … ER -