[Sleep-disordered Breathing and Cardiac Arrhythmias]

Sleep-disordered breathing (SDB) is an important comorbidity in patients with cardiac arrhythmias. Previous studies confirmed associations between supraventricular and ventricular arrhythmias and SDB. In heart failure patients, SDB was also found independently associated with a shorter event-free survival to the occurrence of malignant ventricular arrhythmias requiring appropriate cardioverter-defibrillator therapy. In obstructive sleep apnea, repetitive hypoxemia, mechanical stress (wall tension), arousals from sleep, and activation of the sympathetic nervous system promote cardiac arrhythmias. Pathophysiological concepts for the link between Cheyne-Stokes respiration and malignant arrhythmias are not fully understood and require further research. In addition, large-scale, randomized, controlled trials are awaited to prove whether adequate treatment of SDB is associated with a risk reduction for the occurrence of arrhythmias, in general, and malignant ventricular arrhythmias, in particular, in these patients.