Domenico G Della Rocca1, Maria Albanese2, Fabio Placidi2, Giovanni B Forle3, Luigi Di Biase4,5,6,7, Valentina Ribatti8, Luca Santini9, Francesca Izzi2, Lucia Cicchini10, Mariolina Lovecchio11, Sergio Valsecchi11, Carlo Lavalle12, Andrea Natale4,6,13,14,15,16, Nicola B Mercuri2,17, Andrea Romigi18. 1. Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 N IH-35, Suite 720, Austin, TX, 78705, USA. domenicodellarocca@hotmail.it. 2. Sleep Disorders Centre, Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy. 3. Azienda Ospedaliera - Polo Universitario - "Luigi Sacco", Milan, Italy. 4. Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 N IH-35, Suite 720, Austin, TX, 78705, USA. 5. Albert Einstein College of Medicine, Montefiore Hospital, New York, USA. 6. Department of Biomedical Engineering, University of Texas, Austin, TX, USA. 7. Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy. 8. Cardiac Arrhythmia Research Center, Centro Cardiologico Monzino, IRCCS, Università di Milano, Milan, Italy. 9. G.B. Grassi Hospital, Ostia, Rome, Italy. 10. Department of Cardiovascular Medicine, University of Tor Vergata, Rome, Italy. 11. CRM Department, Boston Scientific Italy, Viale Forlanini 23, 20134, Milan, Italy. 12. Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Policlinico "Umberto" I, Rome, Italy. 13. Interventional Electrophysiology, Scripps Clinic, La Jolla, CA, USA. 14. Metro Health Medical Center, School of Medicine, Case Western Reserve University, Cleveland, OH, USA. 15. Division of Cardiology, Stanford University, Stanford, CA, USA. 16. Electrophysiology and Arrhythmia Services, California Pacific Medical Center, San Francisco, CA, USA. 17. IRCCS Santa Lucia Foundation, Rome, Italy. 18. IRCCS Neuromed, Via Atinense, 18, Pozzilli, IS, Italy.
Abstract
PURPOSE: Sleep-related breathing disorders (SRBD) have been associated with adverse cardiovascular events and prognosis. Some modern pacemakers (PMK) and implantable cardioverter defibrillators (ICD) are equipped with thoracic impedance monitoring systems which allow detecting fluctuations in tidal volume occurring in SRBD. This study aimed at assessing the accuracy of a novel transthoracic impedance-based PMK/ICD sensor for automatic detection of SRBD. METHODS: We prospectively enrolled 31 consecutive patients scheduled for implantation of a PMK or an ICD with sleep respiratory disturbances monitoring capability. The results of unattended home nocturnal recordings expressed as apnea/hypopnea index (AHI) were compared with the respiratory disturbance index (RDI) stored in the cardiac device memory at the time polygraphy was performed. RESULTS: Among the 31 enrolled patients (20 men, mean age 70 ± 8 years), a comparison between the data from polygraphy and cardiac device was feasible in 29 patients. According to the results of home nocturnal recording, a severe SRBD was observed in 7/29 (24.1%) patients. On the basis of receiver-operating characteristic curve analysis of RDI values, the optimal RDI cutoff value to identify severe SRBD was 47 episodes/h (sensitivity 100%, specificity 100%). Bland-Altman agreement analysis of AHI-RDI revealed a bias between measurements of - 11 episodes/h, with limits of agreement - 38 to 15 episodes/h. CONCLUSIONS: In the present study, the novel transthoracic impedance-based monitoring system ApneaScanTM appeared effective in screening PMK and ICD patients for SRBD.
PURPOSE: Sleep-related breathing disorders (SRBD) have been associated with adverse cardiovascular events and prognosis. Some modern pacemakers (PMK) and implantable cardioverter defibrillators (ICD) are equipped with thoracic impedance monitoring systems which allow detecting fluctuations in tidal volume occurring in SRBD. This study aimed at assessing the accuracy of a novel transthoracic impedance-based PMK/ICD sensor for automatic detection of SRBD. METHODS: We prospectively enrolled 31 consecutive patients scheduled for implantation of a PMK or an ICD with sleep respiratory disturbances monitoring capability. The results of unattended home nocturnal recordings expressed as apnea/hypopnea index (AHI) were compared with the respiratory disturbance index (RDI) stored in the cardiac device memory at the time polygraphy was performed. RESULTS: Among the 31 enrolled patients (20 men, mean age 70 ± 8 years), a comparison between the data from polygraphy and cardiac device was feasible in 29 patients. According to the results of home nocturnal recording, a severe SRBD was observed in 7/29 (24.1%) patients. On the basis of receiver-operating characteristic curve analysis of RDI values, the optimal RDI cutoff value to identify severe SRBD was 47 episodes/h (sensitivity 100%, specificity 100%). Bland-Altman agreement analysis of AHI-RDI revealed a bias between measurements of - 11 episodes/h, with limits of agreement - 38 to 15 episodes/h. CONCLUSIONS: In the present study, the novel transthoracic impedance-based monitoring system ApneaScanTM appeared effective in screening PMK and ICDpatients for SRBD.
Authors: W Ward Flemons; Neil J Douglas; Samuel T Kuna; Daniel O Rodenstein; John Wheatley Journal: Am J Respir Crit Care Med Date: 2004-03-15 Impact factor: 21.405
Authors: Dmitry M Yaranov; Athanasios Smyrlis; Natalia Usatii; Amber Butler; Joann R Petrini; Jose Mendez; Mark K Warshofsky Journal: Am J Cardiol Date: 2014-11-29 Impact factor: 2.778
Authors: Giovanni B Forleo; Luca Santini; Massimiliano Campoli; Mario Malavasi; Alberto Scaccia; Maurizio Menichelli; Umberto Riva; Filippo Lamberti; Giovanni Carreras; Serafino Orazi; Valentina Ribatti; Luigi Di Biase; Mariolina Lovecchio; Andrea Natale; Sergio Valsecchi; Francesco Romeo Journal: J Interv Card Electrophysiol Date: 2015-04-28 Impact factor: 1.900
Authors: Apoor S Gami; Gregg Pressman; Sean M Caples; Ravi Kanagala; Joseph J Gard; Diane E Davison; Joseph F Malouf; Naser M Ammash; Paul A Friedman; Virend K Somers Journal: Circulation Date: 2004-07-12 Impact factor: 29.690
Authors: Nancy A Collop; W McDowell Anderson; Brian Boehlecke; David Claman; Rochelle Goldberg; Daniel J Gottlieb; David Hudgel; Michael Sateia; Richard Schwab Journal: J Clin Sleep Med Date: 2007-12-15 Impact factor: 4.062
Authors: Nicola Tarantino; Domenico G Della Rocca; Nicole S De Leon De La Cruz; Eric D Manheimer; Michele Magnocavallo; Carlo Lavalle; Carola Gianni; Sanghamitra Mohanty; Chintan Trivedi; Amin Al-Ahmad; Rodney P Horton; Mohamed Bassiouny; J David Burkhardt; G Joseph Gallinghouse; Giovanni B Forleo; Luigi Di Biase; Andrea Natale Journal: Medicina (Kaunas) Date: 2021-02-26 Impact factor: 2.430
Authors: Michele Magnocavallo; Giampaolo Vetta; Domenico G Della Rocca; Carola Gianni; Sanghamitra Mohanty; Mohamed Bassiouny; Luca Di Lullo; Armando Del Prete; Donatello Cirone; Carlo Lavalle; Cristina Chimenti; Amin Al-Ahmad; J David Burkhardt; G Joseph Gallinghouse; Javier E Sanchez; Rodney P Horton; Luigi Di Biase; Andrea Natale Journal: Card Electrophysiol Clin Date: 2022-01-22
Authors: Michele Magnocavallo; Giampaolo Vetta; Alessia Bernardini; Agostino Piro; Maria Chiara Mei; Martina Di Iorio; Marco Valerio Mariani; Domenico G Della Rocca; Paolo Severino; Raffaele Quaglione; Giuseppe Giunta; Cristina Chimenti; Fabio Miraldi; Carmine Dario Vizza; Francesco Fedele; Carlo Lavalle Journal: Card Electrophysiol Clin Date: 2021-10-30
Authors: Agostino Piro; Michele Magnocavallo; Domenico Giovanni Della Rocca; Matteo Neccia; Giovanna Manzi; Marco Valerio Mariani; Martina Straito; Alessia Bernardini; Paolo Severino; Gino Iannucci; Giuseppe Giunta; Cristina Chimenti; Andrea Natale; Francesco Fedele; Carlo Lavalle Journal: J Cardiovasc Electrophysiol Date: 2020-09-30