Effect of continuous positive airway pressure on ventricular ectopy in heart failure patients with obstructive sleep apnoea

Background: Obstructive sleep apnoea (OSA) elicits a number of cardiovascular perturbations that could lead acutely or chronically to increased ventricular ectopy in patients with heart failure (HF). We tested the hypothesis that treatment of OSA with continuous positive airway pressure (CPAP) in patients with HF would reduce the frequency of ventricular premature beats (VPBs) during sleep in association with reduced sympathetic nervous system activity. Methods: Following optimisation of medical treatment, 18 HF patients with OSA and >10 VPBs per hour of sleep were randomised to a control group (n = 8) or a treatment group who received CPAP (n = 10). The frequency of VPBs and urinary norepinephrine (noradrenaline) concentrations during total sleep time were determined at baseline and after 1 month. Results: Control patients did not experience any significant changes in apnoea-hypopnoea index (AHI), mean nocturnal O2 saturation, or the frequency of VPBs. In contrast, there was a significant reduction in AHI (p