Sleep Apnea-hypopnea Syndrome (SAHS) and Ventricular Arrhythmias
Sleep Apnea-hypopnea Syndrome (SAHS) and Ventricular Arrhythmias
Hypothesis:

 The CPAP treatment diminishes the effect of ventricular arrhythmias in patients with ischemic
 heart disease or dilated myocardiopathy, systolic ventricular disfunction and sleep
 apnea-hypopnea syndrome (SAHS)Objectives: To analyze the incidence of ventricular arrhythmias
 (premature ventricular beat, non-sustained ventricular tachycardia and sustained ventricular
 tachycardia) and appropriate defibrillator therapies in patients with ischemic heart disease
 or dilated myocardiopathy, moderate-severe left ventricular dysfunction,with an implantable
 cardioverter-defibrillator (ICD) and sleep apnea. To study the effect of CPAP on the cardiac
 arrhythmias and on the number of appropriate defibrillator therapies.

 Design:

 Parallel, randomized and single-blinded multicentric study to compare CPAP vs.
 hygienic-dietetic recommendations.

 Patients with SAHS (AHI≥15) and systolic left ventricle dysfunction patients with an ICD.

 Duration: 24 months.
Secondary objectives:

 To compare the prevalence of SAHS in patients with ischemic heart disease or dilated
 myocardiopathy and moderate-severe left ventricle dysfunction with ICD with that of the
 general population. To study the incidence of supraventricular arrhythmias (atrial
 fibrillation, atrial flutter or supraventricular tachycardia) and inappropriate defibrillator
 therapies in these patients. To value the effect of the treatment with CPAP on the above
 mentioned arrhythmias. To relate the effect of ventricular and supraventricular arrhythmias
 with sleep parameters, cardiovascular biomarkers, inflammation and oxidative stress. To
 evaluate the long-term effect of the CPAP on systemic biomarkers in patients with ischemic
 heart disease or dilated myocardiopathy and moderate-severe left ventricle dysfunction. To
 evaluate the long-term effect of CPAP on the quality of life in these patients.

 Sample size:

 224 patients with ischemic heart disease or dilated myocardiopathy and moderate-severe left
 ventricle dysfunction with ICD will be included to randomize 19 SAHS subjects for arm.
Inclusion Criteria:

 -  Previous diagnostic of ischaemic heart disease of dilated myocardiopathy

 -  Ejection fraction of left ventricle < 40%

 -  Patients with implantable cardioverter-defibrillator

 Exclusion Criteria:

 -  Diurnal hypersomnolence with EES > 16

 -  Morbid obesity (BMI > 35 Kg/m2).

 -  Moderate-severe chronic obstructive pulmonary disease (FEV1/FVC < 70 % and FEV1 < 80 %
 of reference).

 -  Known thyroid disease.

 -  Previous treatment with CPAP.