{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:09:05Z","timestamp":1791594545647,"version":"4.3.4"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,11,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The higher cardiovascular variability and the increased prevalence of arrhythmias in patients with obstructive sleep apneas may contribute to their higher rate of fatal events during sleep. In this regard, the use of beta blockers (BB) is debated because they may induce bradyarrhythmias and alter the pattern of heart rate changes induced by apneas. Thus, the aim of our study is to quantify peri\u2010apneic heart\u2010rate swings and prevalence of nocturnal bradyarrhythmias in BB\u2010treated and BB\u2010na\u00efve patients with obstructive sleep apnea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Our real\u2010life, retrospective, cohort study analyzed data from patients with obstructive sleep apnea after a basal cardiorespiratory polysomnography. Among 228 eligible participants, we enrolled 78 BB\u2010treated and 88 BB\u2010na\u00efve patients excluding those treated with antiarrhythmic drugs or pacemakers, or with uninterpretable ECG traces during polysomnography. In each patient, type and frequency of arrhythmias were identified and peri\u2010apneic changes of RR intervals were evaluated for each apnea. BB\u2010treated patients were older and with more comorbidities than BB\u2010na\u00efve patients, but had similar obstructive sleep apnea severity, similar frequency of arrhythmic episodes, and similar prevalence of bradyarrhythmias. Apnea\u2010induced heart\u2010rate swings, unadjusted for age, showed lower RR interval changes in BB\u2010treated (133.5\u00b163.8\u00a0ms) than BB\u2010na\u00efve patients (171.3\u00b187.7\u00a0ms,\n                      <jats:italic>P<\/jats:italic>\n                      =0.01), lower RR interval increases during apneas (58.5\u00b128.5 versus 74.6\u00b140.2\u00a0ms,\n                      <jats:italic>P<\/jats:italic>\n                      =0.01), and lower RR interval decreases after apneas (75.0\u00b142.4 versus 96.7\u00b155.5\u00a0ms,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">BB appear to be safe in patients with obstructive sleep apnea because they are not associated with worse episodes of nocturnal bradyarrhythmias and even seem protective in terms of apnea\u2010induced changes of heart rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.015926","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T06:18:05Z","timestamp":1603779485000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Nocturnal Arrhythmias and Heart\u2010Rate Swings in Patients With Obstructive Sleep Apnea Syndrome Treated With Beta Blockers"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1033-6053","authenticated-orcid":false,"given":"Carolina","family":"Lombardi","sequence":"first","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS Sleep Disorders Center San Luca Hospital Milan Italy"},{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca Milan 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Fondazione Don Carlo Gnocchi Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9402-7439","authenticated-orcid":false,"given":"Gianfranco","family":"Parati","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS Sleep Disorders Center San Luca Hospital Milan Italy"},{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca Milan 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