Apnea: ‘Sleeping Gun’ in Sudden Death?

After adjustment for other risk factors, each 10% decrease in the lowest nocturnal oxygen saturation among adults undergoing a first-time polysomnogram for suspected sleep-disordered breathing was associated with a 14% greater risk of sudden cardiac death or resuscitated cardiac arrest (HR 1.14, 95% CI 1.01 to 1.27), according to Virend Somers, MD, PhD, of the Mayo Clinic in Rochester, Minn., and colleagues.

Sleep factors associated with a significantly greater likelihood of remaining free from sudden cardiac death or resuscitated cardiac arrest included an apnea-hypopnea index of less than 20 events per hour (HR 1.60, 95% CI 1.14-2.24), a mean nocturnal oxygen saturation of 93% or higher (HR 2.93, 95% CI 1.98-4.33), and a lowest nocturnal oxygen saturation of 78% or higher (HR 1.81, 95% CI 1.28-2.56), the researchers reported online in the Journal of the American College of Cardiology.

via Apnea: ‘Sleeping Gun’ in Sudden Death

Yes.  CPAP compliance matters.

Afib Linked to Sudden Cardiac Death

Atrial fibrillation may raise the risk of sudden cardiac death, according to findings from two large population-based cohorts.

The risk of sudden cardiac death was elevated 3.26-fold with incident atrial fibrillation in multivariate analysis of the ARIC (Atherosclerosis Risk in Communities) study, Lin Y. Chen, MD, MS, of the University of Minnesota Medical School in Minneapolis, and colleagues found.

via Afib Linked to Sudden Cardiac Death, Too.

Got Long QT? No Citalopram For You

  • Patients with congenital long QT syndrome are at particular risk of torsades de pointes, ventricular tachycardia and sudden death when given drugs that prolong the QT interval. Nevertheless, the labeling recommendation for patients with congenital long QT syndrome has been changed from “contraindicated” to “not recommended,” because it is recognized that there may be some patients with this condition who could benefit from a low dose of citalopram and who lack viable alternatives. Similarly, the drug is not recommended for those who have bradycardia, hypokalemia or hypomagnesemia, recent acute myocardial infarction, or uncompensated heart failure.
  • Although citalopram use should be avoided, if possible, in patients with certain conditions because of the risk of QT prolongation, ECG monitoring and electrolyte monitoring should be performed if citalopram must be used in these patients.
  • The maximum recommended dose of citalopram is 20 mg per day for patients with hepatic impairment, adults older than 60, patients who are CYP2C19 poor metabolizers, and those who are taking cimetidine or another CYP2C19 inhibitor concurrently.
  • Citalopram should be discontinued in patients who are found to have persistent QT measurements (corrected for heart rate) greater than 500 milliseconds.

via FDA Clarifies Citalopram Warnings Linked to Heart Rhythm Abnormalities — AAFP News Now — American Academy of Family Physicians.