Central Sleep Apnea Induces Ventricular Bigeminus

Ventricular ectopy1 and central sleep apnea2 are independent negative predictors of excess mortality in patients with heart failure. Recent studies have established an association between central sleep apnea and ventricular ectopy.3 Because the 2 conditions share many common risk factors, however, a causal relationship remains unclear. Here, we present images of a nocturnal polygraphy that provide evidence for a causal relationship between central sleep apnea and ventricular ectopic beats. A 79-year-old man (body mass index, 24.8 kg/m2; height, 1.74 m) with known ischemic heart failure (ejection fraction, 30%) was admitted with suspected cardiac syncopes. The 24-hour ECG revealed frequent monomorphic ventricular ectopic beats with intermittent episodes of a …