Ghassan Moubarak1, Abdeslam Bouzeman2, Thibaut de Geyer d'Orth3, Claire Bouleti4, Christine Beuzelin5, Serge Cazeau2. 1. Department of Electrophysiology and Pacing, Groupe Hospitalier Paris Saint-Joseph, Paris, France. Electronic address: gmoubarak@rythmologie.paris. 2. Department of Electrophysiology and Pacing, Groupe Hospitalier Paris Saint-Joseph, Paris, France. 3. LivaNova CRM SAS, Clamart, France. 4. Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France. 5. Department of Pulmonary Medicine, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
Abstract
BACKGROUND: Obstructive sleep apnea (OSA) is associated with several cardiovascular conditions. Some pacemakers feature specific algorithms detecting respiratory cycles and deriving indices well correlated with the identification of polysomnography-confirmed severe OSA. OBJECTIVES: The purposes of this study were to analyze respiratory disturbances measured by a validated algorithm in clinical practice and to describe their variability over time and their association with atrial fibrillation. METHODS: Fifty-eight patients implanted with dual-chamber LivaNova REPLY 200 DR or KORA 100 DR pacemakers measuring a respiratory disturbance index (RDI) were included. An RDI >20 events per hour of sleep is well correlated with severe OSA as determined by polysomnography. Patients with >10% nights with invalid RDI measurements were excluded. RESULTS: The RDI could be measured during 98% of nights. During a mean follow-up of 187 ± 123 days, the individual mean RDI was 19.9 ± 12.7 and was superior to 20 in 24 patients (41%). An RDI >20 events/h in at least 1 night was observed in 52 patients (90%). The mean day-to-day RDI variability in individual patients was 19% ± 21%. Patients with the highest burden of severe OSA (as defined by ≥75% of nights with RDI >20 events/h) were older, had a higher prevalence of hypertension, and were more often implanted for atrioventricular block than patients with lower burden of severe OSA. No RDI burden or cutoff was a predictor of atrial fibrillation occurrence. CONCLUSION: OSA is frequent in patients with a pacemaker and is reliably detected by pacemakers. OSA is highly variable and could probably be best analyzed in terms of burden. Copyright Â
BACKGROUND:Obstructive sleep apnea (OSA) is associated with several cardiovascular conditions. Some pacemakers feature specific algorithms detecting respiratory cycles and deriving indices well correlated with the identification of polysomnography-confirmed severe OSA. OBJECTIVES: The purposes of this study were to analyze respiratory disturbances measured by a validated algorithm in clinical practice and to describe their variability over time and their association with atrial fibrillation. METHODS: Fifty-eight patients implanted with dual-chamber LivaNova REPLY 200 DR or KORA 100 DR pacemakers measuring a respiratory disturbance index (RDI) were included. An RDI >20 events per hour of sleep is well correlated with severe OSA as determined by polysomnography. Patients with >10% nights with invalid RDI measurements were excluded. RESULTS: The RDI could be measured during 98% of nights. During a mean follow-up of 187 ± 123 days, the individual mean RDI was 19.9 ± 12.7 and was superior to 20 in 24 patients (41%). An RDI >20 events/h in at least 1 night was observed in 52 patients (90%). The mean day-to-day RDI variability in individual patients was 19% ± 21%. Patients with the highest burden of severe OSA (as defined by ≥75% of nights with RDI >20 events/h) were older, had a higher prevalence of hypertension, and were more often implanted for atrioventricular block than patients with lower burden of severe OSA. No RDI burden or cutoff was a predictor of atrial fibrillation occurrence. CONCLUSION: OSA is frequent in patients with a pacemaker and is reliably detected by pacemakers. OSA is highly variable and could probably be best analyzed in terms of burden. Copyright Â
Authors: Domenico G Della Rocca; Maria Albanese; Fabio Placidi; Giovanni B Forle; Luigi Di Biase; Valentina Ribatti; Luca Santini; Francesca Izzi; Lucia Cicchini; Mariolina Lovecchio; Sergio Valsecchi; Carlo Lavalle; Andrea Natale; Nicola B Mercuri; Andrea Romigi Journal: J Interv Card Electrophysiol Date: 2019-10-23 Impact factor: 1.900
Authors: Dominik Linz; Mathias Baumert; Lien Desteghe; Kadhim Kadhim; Kevin Vernooy; Jonathan M Kalman; Dobromir Dobrev; Michael Arzt; Manu Sastry; Harry J G M Crijns; Ulrich Schotten; Martin R Cowie; R Doug McEvoy; Hein Heidbuchel; Jeroen Hendriks; Prashanthan Sanders; Dennis H Lau Journal: Int J Cardiol Heart Vasc Date: 2019-10-18