SLEEP APNEA IS ASSOCIATED WITH TACHYARRHYTHMIAS IN DILATED CARDIOMYOPATHY: A NATIONAL INPATIENT SAMPLE ANALYSIS

SESSION TITLE: Sleep, Breathing, and the Heart SESSION TYPE: Original Investigations PRESENTED ON: 10/11/2023 07:15 am - 08:15 am PURPOSE: Sleep apnea and Dilated Cardiomyopathy (DCM) have individually been associated with heart failure and arrhythmias. Few studies have shed light on the impact of sleep apnea on worsening heart failure in DCM and its reversibility with treatment. We aim to study the burden and impact of sleep apnea on arrhythmias in a cohort of patients with DCM. METHODS: National Inpatient sample 2020 was queried for adult patients (age > 18 yrs) with Dilated Cardiomyopathy. These patients were further divided into patients with and without sleep apnea. Prevalence of Arrhythmias and other relevant co-morbidities were studied in both groups. Multivariate regression analysis was performed to assess the impact of tachyarrhythmias (atrial fibrillation [AF], atrial flutter, supraventricular tachycardia [SVT], ventricular tachycardia [VT], and ventricular fibrillation [VF]) on mortality, length of stay and total hospital cost in patients with DCM and sleep apnea. RESULTS: A total of 221430 patients with DCM were hospitalized in 2020 with a mean age of 64 years. The prevalence of sleep apnea in these patients was 17.29% (n=38064) of which 25.89% were females. In patients with DCM and sleep apnea, obesity (52.34% vs 18.74%; P<0.0001), chronic heart failure (31.13% vs 28.32%; P<0.0001) and hypothyroidism (15.26% vs 13.11%; P<0.0001) were more prevalent while alcohol abuse (2.81% vs 3.99%; P<0.0001) was less prevalent as compared to those without sleep apnea. There was no statistical difference in the prevalence of old MI, electrolyte disturbances, or hypertension between the two groups. The prevalence of AF (32.4% vs 28.1%; P<0.001), atrial flutter (10.2% vs 7.6%; P<0.001), and VT (17.6% vs 15.1%) was higher in patients with sleep apnea and DCM while no statistically significant difference was found with VF (2.2% vs 2.8%; P=0.7), SVT (4.58% vs 4.88%;P=0.27), and other bradyarrhythmias. Multivariate regression analysis revealed a 27% higher odds (OR- 1.27; C.I:1.21-1.34; P<0.0001) of developing tachyarrhythmias due to sleep apnea in patients with DCM after adjusting for relevant confounders. Adjusted analysis also revealed higher odds of mortality (OR=2.13; C.I: 1.62-2.80; P<0.001), length of stay (OR=1.20; C.I: 1.10-1.56; P<0.001), and total hospital cost (OR: $34428; C.I: 25616-43240; P<0.001) with tachyarrhythmias in patients with DCM and sleep apnea. CONCLUSIONS: Sleep apnea is independently linked to developing tachyarrhythmias in patients with DCM. These heart rhythm abnormalities are associated with increased mortality, total length of stay and total hospital costs in these patients. CLINICAL IMPLICATIONS: The treatment of sleep apnea has been shown to improve outcomes in patients with heart failure and DCM. Further studies need to be done to see if treating sleep apnea effectively can improve patient outcomes in patients with tachyarrhythmias and DCM also. Patients with DCM should be aggressively screened for sleep apnea if clinical suspicion is high to prevent arrhythmias and worse outcomes associated with them. DISCLOSURES: No disclosure on file for Cesar Ayala Rodriguez No relevant relationships by Dishang Bhavsar No relevant relationships by Pradeep Kumar Devarakonda No relevant relationships by Vishal Dhulipala No relevant relationships by Sukhjeet Kaur No relevant relationships by Suganya Manoharan No relevant relationships by Dhairya Nanavaty No relevant relationships by Saikrishna Patibandla No relevant relationships by Sarath Reddy No relevant relationships by Ankushi Sanghvi No disclosure on file for Sohrab Singh No relevant relationships by RISHAV Sinha No relevant relationships by Seungmo Suh No relevant relationships by Viswanath Vasudevan