REM-associated bradyarrhythmia (a clinical case)
https://doi.org/10.18705/1607-419X-2021-27-5-583-590
Abstract
The article presents an observation of a rare clinical arrhythmia — REM-associated advanced atrioventricular block 2nd degree. The absence of structural abnormalities of the heart, the young age and the need for additional methods of instrumental examination for diagnosis (polysomnography, test with the active orthostasis test) are important features of the case. Despite the orphan nature of this arrhythmia, the correct diagnosis is important for the choice of the management strategy choice.
About the Authors
D. V. Pakhomova
National Research Center of Preventive Therapy and Medicine
Russian Federation
Russian Federation
Darya V. Pakhomova, MD, Cardiologist
10 Petroverigsky Lane, Moscow, 101990
M. V. Agaltsov
National Research Center of Preventive Therapy and Medicine
Mikhail V. Agaltsov, MD, PhD, Senior Researcher, Department of Fundamental and Applied Aspects of Obesity
10 Petroverigsky Lane, Moscow, 101990
E. Yu. Andreenko
National Research Center of Preventive Therapy and Medicine
Elena Yu. Andreenko, MD, PhD, Senior Researcher, Department of Clinical Cardiology
10 Petroverigsky Lane, Moscow, 101990
O. M. Drapkina
National Research Center of Preventive Therapy and Medicine
Oksana M. Drapkina, MD, PhD, Professor, Corresponding Member of the Russian Academy of Sciences, Head, Department of Fundamental and Applied Aspects of Obesity
10 Petroverigsky Lane, Moscow, 101990
References
1. Oganesyan GA, Romanova IV, Aristakesyan EA, Vataev SI, kuzik VV. Evolution of the wake-sleep cycle and telencephalicdiencephalic interaction in vertebrates. Russ J Phys. 2011;97:337–350. In Russian.
2. Pigarev IN. Visceral theory of sleep. J High Nerv Activ. 2013;63(1):86–104. In Russian.
3. Tzivoni D, Stern S. Electrocardiographic pattern during sleep in healthy subjects and in patients with ischemic heart disease. J Electrophysiol. 1973;6(3):225–230.
4. Aserinsky E. Periodic respiratory pattern occurring in conjuction with eye movements during sleep. Science. 1965; 150(3697):763–766.
5. Synder F, Hobson JA, Morrison DF, Goldfrank F. Changes in respiration, heart rate and systolic blood pressure in human sleep. J Appl Physiol. 1964;19:417–422.
6. Lavery CE, Mittleman MA, Cohen MC, Muller JE, Verrier RL. Nonuniform nighttime distribution of acute cardiac events: a possible effect of sleep states. Circulation. 1997;96(10):3321–3327.
7. Yamashita T, Murakawa Y, Hayami N, Sezaki K, Inoue M, Fukui E et al. Relation between aging and circadian variation of paroxysmal atrial fibrillation. Am J Cardiol. 1998;82(11):1364–1367.
8. Rostagno C, Taddei T, Paladini B, Modesti PA, Utari P, Bertini G. The onset of symptomatic atrial fibrillation and paroxysmal supraventricular tachycardia is characterized by different circadian rhythms. Am J Cardiol. 1993;71(5):453–455.
9. Manfredini R, Gallerani M, Portaluppi F, Salmi R, Chierici F, Fersini C. Circadian variation in the occurrence of paroxysmal supraventricular tachycardia in clinically healthy subjects. Chronobiol Int. 1995;12(1):55–61.
10. Irwin JM, McCarthy EA, Wilkinson WE, Pritchett EL. Circadian occurrence of symptomatic paroxysmal supraventricular tachycardia in untreated patients. Circulation. 1988;77(2):298–300.
11. Aronow WS, Ahn C. Circadian variation of primary cardiac arrest or sudden cardiac death in patients aged 62 to 100 years (mean 82). Am J Cardiol. 1993;71(16):1455–1456.
12. Hohnloser SH, Zabel M, Just H, Raeder EA. Relation of diurnal variation of ventricular repolarization to ventricular ectopic activity and modification bysotalol. Am J Cardiol. 1993;71(5): 475–478.
13. Guilleminault C, Pool P, Motta J, Gillis AM. Sinus arrest during REM sleep in young adults. N Engl J Med. 1984;311(16): 1006–1010.
14. Holty JE, Guilleminault C. REM-related bradyarrhythmia syndrome. 2011;15(3):143–151. doi:10.1016/j.smrv.2010.09.001
15. Janssens W, Willems R, Pevernagie D, Buyse B. REM sleep-related brady-arrhythmia syndrome. Sleep Breath. 2007; 11(3):195–199.
16. Verrier RL, Lau TR, Wallooppillai U, Quattrochi J, Nearing BD, Moreno R et al. Primary vagally mediated decelerations in heart rate during tonic rapid eye movement sleep in cats. Am J Physiol. 1998;274(4):R1136–R1141.
17. McCarley RW, Massaquoi SG. A limit cycle mathematical model of the REM sleep oscillator system. Am J Physiol. 1986;251(6Pt2):R1011–R1029.
18. Vasquez J, Baghdoyan HA. Basal forebrain acetylcholine release during REM sleep is significantly greater than during waking. Am J Physiol. 2001;280(2):R598–R601.
19. Santinelli V, Chiariello M, Clarizia M, Condorelli M. Sick sinus syndrome: the role of hypervagotonia. Int J Cardiol. 1984;5(4):532–535.
20. James TN, Bear ES, Frink RJ, Urthaler F. Pharmacologic production of atrioventricular block with and without initial bundle branch block. J Pharmacol Exp Ther. 1971;179(2):338–346.
21. Lamperti G, Champeroux P, Martel E, Colibretti ML, Santoro L, Imbimbo BP. Hemodynamic effects of MF 10058, a new cardioselective muscarinic M2 receptor antagonist, in conscious dogs. Eur J Pharmacol. 2000;406(1):93–98.
22. Otsuka K, Kawakami T, Saito H, Watanabe H. REM sleep and bradyarrhythmia episodes in rats. J Electrocardiol. 1989;22(3):235–240.
23. Saito H, Otsuka K, Sato T, Yoshimatsu K, Kaba H, Seto K et al. Arrhythmogenic properties of paradoxical sleep. Am Heart J. 1983;105(5):875–877.
24. Otsuka K, Ikari M, Ichimaru Y, Saito H, Kawakami T, Kaba H et al. Experimental study on the relationship between cardiac arrhythmias and sleep states by ambulatory ECG-EEC monitoring. Clin Cardiol. 1986;9(7):305–313.
25. Viola AU, Simon C, Doutreleau S, Ehrhart J, Geny B, Piquard F et al. Abnormal heart rate variability in a subject with second degree atrioven-tricular blocks during sleep. Clin Neurophysiol. 2004;115(4):946–950.
26. Koehler U, Fus E, Grimm W, Pankow W, Schafer H, Stammnitz A et al. Heart block in patients with obstructive sleep apnoea: pathogenetic factors and effects of treatment. Eur Respir J. 1998;11(2):434–439.
27. Gillis AM. Cardiac arrhythmias during sleep. Compr Ther. 1985;11(4):66–71.
28. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS et al. ACC/AHA/HRS2008 Guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2008;51(21):1–62.
29. Glikson M, Nielsen J C, Kronborg M B, Michowitz Y, Auricchio A, Barbash I M, et al. ESC Scientific Document Group, 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA), European Heart Journal, 2021; 42(35): 3427–3520, https://doi.org/10.1093/eurheartj/ehab364
30. Клинические рекомендации Минздрава РФ. Брадиаритмии и нарушения проводимости. 2020. 113 с. Доступно на: https://www.scardio.ru/content/Guidelines/2020/Clinic_rekom_Bradiaritmiya.pdf.
Review
For citations:
Pakhomova D.V., Agaltsov M.V., Andreenko E.Yu., Drapkina O.M. REM-associated bradyarrhythmia (a clinical case). "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2021;27(5):583-590. (In Russ.) https://doi.org/10.18705/1607-419X-2021-27-5-583-590
Views:
664
Email this article 