Diagnostic features analysis of rapid eye movement sleep-related bradyarrhythmia syndrome
Lin Lin1,2, Li Chan1,2, Lin Jingru3, Xu Rui2
1Weifang Medical University, Weifang 261053, China; 2Department of Cardiology, the First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan 250014, China; 3Department of Cardiology, Shandong Provincial Third Hospital, Jinan 250031, China
Abstract：ObjectiveTo explore the diagnostic features and treatment of rapid eye movement (REM) sleeprelated bradyarrhythmia syndrome. MethodsThe clinical data of the patient with bradyarrhythmia syndrome related to REM sleep admitted to Cardiology Department of Shandong Provincial Qianfoshan Hospital on September 14, 2017 were analyzed retrospectively, and the relevant literatures were reviewed. ResultsThe results of 24-hour holter showed sinus tachycardia， sinus arrest (sinus arrest was more than 2.0s for 525 times, and the longest stop was 3.13s)， first degree, second degree Ⅰ, second degree Ⅱ atrioventricular block and occasional supraventricular premature beat. Sinus tachycardia mainly occured in daytime after movement, sinus arrest and atrioventricular block mainly occured from 24∶00 to 7∶00am. Heart rate variability showed the standard deviation of RR interval of sinus heart beat was 121ms, the peak appeared at night, the fastest heart rate was 169 times/min within 24hours, no ST-T change. No abnormality was found in myocardial enzyme, doppler echocardiography and chest radiograph. After removing the inducement of sympathetic nerve excitation, the patient′s arrhythmia at night was significantly improved. ConclusionThe hyperactivity of the sympathetic during the day maybe one of the causes of the bradyarrhythmia related to REM sleep.
