0956 Prevalence Of Nocturnal Tachyarrhythmias and Long-term Functional Outcome in Patients With Obstructive Sleep Apena Syndrome and Acute Ischemic Stroke

Abstract

Introduction: Stroke is a major cause of disability and death worldwide. The obstructive sleep apnea syndrome (OSAS) is a known risk factor of stroke. The prevalence of OSAS is high in stroke patients and has been related to atrial tachyarrhythmias. Arrhythmias during sleep occur frequently in OSA patients, even though the prevalence of OSAS and sleep tachyarrhythmias in stroke patients and its relationship with the long-term functional outcome is not clear. The aim of our study was to identify the prevalence of atrial arrhythmias during sleep in patients with OSAS and acute ischemic stroke as well as its repercussion in the functional recovery. Methods: Prospective cohort of consecutive patients with acute ischemic stroke. We performed 24-hour cardiac monitoring along with a portable sleep study. An apnea/hypopnea index (AHI) > 15 was used to establish the diagnosis of OSAS. Atrial arrhythmias were defined as cardiac rhythm variants that had the impulse formation or reentry circuit originated above the bifurcation of the bundle of His. All tachyarrhythmias (sinus tachycardia, supraventricular tachycardia, atrial fibrillation, atrial flutter) present during sleep were included. An evaluation at 3 and 6-months after the patient's hospital discharge was carried out to evaluate their functional independence. Results: A total of 56 patients with a mean age of 60.3 ±14.4 were included. We classified 32 (57%) subjects with OSAS. Risk factors for OSAS did not differ between groups. Prevalence of atrial tachyarrhythmias during sleep (p= <0.001) was significantly higher in patients with OSAS. Patients with both, OSAS and tachyarrhythmias had a worse NIHSS (p= 0.043) and Rankin at discharge (p= 0.005) and presented poorer functional independence at 3 (p= 0.006) and 6-months (p= 0.016). Conclusion: Prevalence of arrhythmias is frequent in patients with obstructive sleep apnea syndrome and acute ischemic stroke. Its clinical relevance impacts on the functional long-term outcome. Therefore, the identification of OSAS and arrhythmias must be prioritized in acute stroke patients. Further studies with a large population are needed to support our findings.