Dominik Linz1, Anthony G Brooks2, Adrian D Elliott1, Chrishan J Nalliah3, Jeroen M L Hendriks1, Melissa E Middeldorp1, Celine Gallagher1, Rajiv Mahajan1, Jonathan M Kalman3, R Doug McEvoy4, Dennis H Lau1, Prashanthan Sanders5. 1. Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia. 2. Cardiac Rhythm Management, MicroPort, Scoresby, Victoria, Australia. 3. Department of Cardiology, Royal Melbourne Hospital and Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia. 4. Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, and Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia. 5. Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia. Electronic address: prash.sanders@adelaide.edu.au.
Abstract
OBJECTIVES: This study sought to determine night-to-night variability in the severity of sleep-disordered breathing (SDB) and the dynamic intraindividual relationship to daily risk of incident atrial fibrillation (AF) by using simultaneous long-term day-by-day SDB and AF monitoring. BACKGROUND: Night-to-night variability in SDB severity may result in a dynamic exposure to SDB related conditions impacting the timing and extent of cardiovascular responses. METHODS: This study was an observational cohort study. Daily data for AF burden and average respiratory disturbance index (RDI) were extracted from pacemakers capable of monitoring nightly SDB and daily AF burden in 72 patients. Nightly RDI values were grouped into quartiles of severity within each patient. AF burdens of >5 min, >1 h, and >12 h were the outcome variables. RESULTS: A total of 32% of patients had a mean RDI of ≥20/h, indicative of overall severe SDB. There was significant night-to-night variation in RDI reflected by an absolute SD of ±6.3 events/h (range 2 to 14 events/h) within any given patient. Within each patient, the nights with the highest RDI (in their highest quartile) conferred a 1.7-fold (1.2 to 2.2; p < 0.001), 2.3-fold (1.6 to 3.5; p < 0.001), and 10.2-fold (3.5 to 29.9; p < 0.001) increase risk of having at least 5 min, 1 h, and 12 h, respectively, of AF during the same day compared with the best sleep nights (in their lowest quartiles). CONCLUSIONS: There is considerable night-to-night variability in SDB severity which cannot be detected by 1 single overnight sleep study. SDB burden may be a better metric with which to assess the extent of dynamic SDB related cardiovascular responses such as daily AF risk than the categorical diagnosis of SDB. (Night-to-Night Variability in Severity of Sleep Apnea and Daily Dynamic Atrial Fibrillation Risk [VARIOSA-AF]; ACTRN 12618000757213). Crown
OBJECTIVES: This study sought to determine night-to-night variability in the severity of sleep-disordered breathing (SDB) and the dynamic intraindividual relationship to daily risk of incident atrial fibrillation (AF) by using simultaneous long-term day-by-day SDB and AF monitoring. BACKGROUND: Night-to-night variability in SDB severity may result in a dynamic exposure to SDB related conditions impacting the timing and extent of cardiovascular responses. METHODS: This study was an observational cohort study. Daily data for AF burden and average respiratory disturbance index (RDI) were extracted from pacemakers capable of monitoring nightly SDB and daily AF burden in 72 patients. Nightly RDI values were grouped into quartiles of severity within each patient. AF burdens of >5 min, >1 h, and >12 h were the outcome variables. RESULTS: A total of 32% of patients had a mean RDI of ≥20/h, indicative of overall severe SDB. There was significant night-to-night variation in RDI reflected by an absolute SD of ±6.3 events/h (range 2 to 14 events/h) within any given patient. Within each patient, the nights with the highest RDI (in their highest quartile) conferred a 1.7-fold (1.2 to 2.2; p < 0.001), 2.3-fold (1.6 to 3.5; p < 0.001), and 10.2-fold (3.5 to 29.9; p < 0.001) increase risk of having at least 5 min, 1 h, and 12 h, respectively, of AF during the same day compared with the best sleep nights (in their lowest quartiles). CONCLUSIONS: There is considerable night-to-night variability in SDB severity which cannot be detected by 1 single overnight sleep study. SDB burden may be a better metric with which to assess the extent of dynamic SDB related cardiovascular responses such as daily AF risk than the categorical diagnosis of SDB. (Night-to-Night Variability in Severity of Sleep Apnea and Daily Dynamic Atrial Fibrillation Risk [VARIOSA-AF]; ACTRN 12618000757213). Crown
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
Authors: Astrid N L Hermans; Rachel M J van der Velden; Monika Gawalko; Dominique V M Verhaert; Lien Desteghe; David Duncker; Martin Manninger; Hein Heidbuchel; Ron Pisters; Martin Hemels; Laurent Pison; Afzal Sohaib; Arian Sultan; Daniel Steven; Petra Wijtvliet; Robert Tieleman; Dhiraj Gupta; Dobromir Dobrev; Emma Svennberg; Harry J G M Crijns; Nikki A H A Pluymaekers; Jeroen M Hendriks; Dominik Linz Journal: Clin Cardiol Date: 2020-10-08 Impact factor: 2.882
Authors: Nicholas Harrington; Quan M Bui; Zhe Wei; Brandon Hernandez-Pacheco; Pamela N DeYoung; Andrew Wassell; Bayan Duwaik; Akshay S Desai; Deepak L Bhatt; Parag Agnihotri; Robert L Owens; Todd P Coleman; Kevin R King Journal: Sci Rep Date: 2021-12-21 Impact factor: 4.996
Authors: Bastien Lechat; Ganesh Naik; Amy Reynolds; Atqiya Aishah; Hannah Scott; Kelly A Loffler; Andrew Vakulin; Pierre Escourrou; R Doug McEvoy; Robert J Adams; Peter G Catcheside; Danny J Eckert Journal: Am J Respir Crit Care Med Date: 2022-03-01 Impact factor: 30.528
Authors: G M Traaen; B Øverland; L Aakerøy; T E Hunt; C Bendz; L Sande; S Aakhus; H Zaré; S Steinshamn; O G Anfinsen; J P Loennechen; L Gullestad; H Akre Journal: Int J Cardiol Heart Vasc Date: 2019-12-19
Authors: Nikki A H A Pluymaekers; Astrid N L Hermans; Melissa E Middeldorp; Kadhim Kadhim; Harry J G M Crijns; Prashanthan Sanders; Dominik Linz Journal: Int J Cardiol Heart Vasc Date: 2019-11-19