Cardiac arrhythmias during sleep in morbidly obese sleep‐apneic patients before and after gastric bypass surgery

Fourteen morbidly obese patients scheduled for gastric bypass surgery were diagnosed preoperatively as suffering from sleep apnea syndrome. There were 13 males and 1 female aged 24 to 59 years. Mean preoperative excessive body weight was 222 ±38%; mean apnea index prior to surgery was 84 ±44. A whole night lead II ECG tracing was performed as part of the polyhypno‐graphic recordings and was evaluated for cardiac arrhythmias. Studies were performed in all patients preoperatively and 6 months thereafter. Statistical analysis was done using the Student's paired t‐test. In this group a high incidence of atrial and ventricular arrhythmias was found. Marked sinus arrhythmia was encountered in all patients and extreme sinus bradycardia in 4 of them. In a consecutive sleep study performed 6 months postoperatively most cardiac arrhythmias disappeared. Marked sinus arrhythmia persisted in only two patients and severe ventricular premature beats (Lown's grade III‐IV), found preoperatively in all patients, were still present postoperatively in only two, although in a much milder form. Surgical weight reduction, therefore, is a valuable method in the abolishment of life‐threatening cardiac arrhythmias of the morbidly obese sleep‐apneic patient.