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Impact of nocturnal oxygen therapy for central sleep apnea syndrome on nocturnal premature ventricular contractions

Takeshi Tomita, Takeo Higashikata, Ei-ichiro Mawatari, Tsunemi Koji, Harumi Sasaki, KojiYoshie, Yasutaka Oguchi, Takahiro Takeuchi, Ayako Okada & Uichi Ikeda

We report here a case of central sleep apnea syndrome associated with frequent nocturnal premature ventricular contractions (PVCs) that were successfully eliminated using nocturnal oxygen therapy. He was admitted to our hospital for chest discomfort during the night. The symptoms frequently woke him up during sleep. His electrocardiogram (ECG) showed sinus rhythm accompanied by PVCs. The 24 hour ambulatory ECG detected frequent PVCs during the night (more than 1000 beats/hour). Additionally, polysomnography demonstrated severe central sleep apnea syndrome, the so-called Cheyne-Stokes respirations (apnea-hypopnea index 48/ hour). He received oxygen at a rate of 2 liter/min only during sleep. After nocturnal nasal oxygen therapy, the PVCs became significantly fewer and his symptoms disappeared. This case report suggests the possibility of an impact of oxygen inhalation during sleep in patients with central SAS on the prevention of ventricular arrhythmias during both the daytime and night. However, further well-established randomized, controlled studies are needed to confirm these effects.