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Triggering of Nocturnal Arrhythmias by Sleep-Disordered Breathing Events

Ken Monahan, MD^_*, Amy Storfer-Isser, MS, Reena Mehra, MD, MS, Eyal Shahar, MD, MPH, Murray Mittleman, MD, DrPH, Jeff Rottman, MD^_*, Naresh Punjabi, MD, PhD^¶, Mark Sanders, MD^#, Stuart F. Quan, MD^||,_**, Helaine Resnick, PhD and Susan Redline, MD, MPH^,_*

^_* Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
Department of Medicine and Center for Clinical Investigation, Case School of Medicine, Cleveland, Ohio
Division of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona
Departments of Medicine and Epidemiology, Harvard Medical School, Boston, Massachusetts
^|| Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
^¶ Departments of Medicine and Epidemiology, Johns Hopkins School of Medicine, Baltimore, Maryland
^# Division of Pulmonology, Allergy, and Critical Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
^_** Arizona Respiratory Center, University of Arizona College of Medicine, Tucson, Arizona
Department of Medicine, Georgetown University School of Medicine, Washington, DC

View larger version (12K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Design of Case-Crossover Analysis The 90-s hazard period immediately preceding an arrhythmia is evaluated for respiratory disturbances. Three randomly chosen referent periods of sinus rhythm, which precede the index arrhythmia by at least 6 min, are also examined for respiratory disturbances. If any part of a respiratory disturbance occurs during a hazard or referent period, that period is considered "exposed."