PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME AFTER CORONARY ARTERY BYPASS GRAFTING WITH PAROXYSMS OF ATRIAL FIBRILLATION IN POSTOPERATIVE PERIOD: THE FIRST RESULTS OF STUDY
Objective. The obstructive sleep apnea syndrome (OSA) is a risk factor for the development of atrial fibrillation (AF). In turn, AF is the most frequent postoperative complication of coronary artery bypass grafting (CABG). We conducted a study of the possible relationship between OSA and postoperative paroxysms of AF, and the frequency of the complication development in patients with OSA who undergo CABG. Material and methods. A 32 candidates scheduled for a CABG was routinely evaluated for age, gender, body mass index (BMI), clinical examination, 24-hour cardio-respiratory monitoring (CRM), blood tests and medications. In the postoperative period, bedside monitoring was performed about real paroxysms of AF, extubation time was evaluated, repeated CRM was performed on the third day. Results. Patients are divided into two groups: group 1 (OSA-0) - 17 patients with apnea/hypnopnea index (AHI) less than 15 per hour, group 2 (OSA-1) - 15 patients with AHI more than 15 per hour. In all patients with initial respiratory disturbances in sleep, an increase in AHI after surgery was observed. Paroxysms of atrial fibrillation appeared in 11 patients: one patient from OSA-0 group and ten patients from OSA-1 group ( p <0,05). Conclusion. In patients with cardiac ischemia high prevalence of OSA is was observed. Its severity is significantly increased in the postoperative period, and the development of postoperative AF in patients after CABG is more common in patients with heavier OSA.