Background
New generation pacemaker allow the assessment day by day of sleep disordered breathing (SDB) based on impedance measurement. A recent study demonstrated that incidence of AF is higher in case of severe SA monitored by pacemaker
Purpose
The aim was to compare the atrial fibrillation (AF) burden between patients with severe and non-severe sleep apnea (SA) detected with pacemakers monitoring (SDB).
Methods
This retrospective study was carried out at our University Hospital. We included all patients with Microport CRM pacemaker implanted from 2013 to 2016 at our university hospital. Exclusion criteria were inactivation of sleep apnea monitoring (SAM), history of sleep apnea, missing data or invalid data. AF burden was assessed according to Fallback mode switch (FMS) duration. Respiratory disturbance index (RDI) was calculated as the average number of events (ventilation pause and reductions) per number of hours of monitoring. Patients with RDI<20/h were compared with patients with RDI≥20/h (considered as severe SA group).
Results
404 patients (mean age = 79.7±10 years; 52.0% men) were included. The most prevalent indication for cardiac pacing was atrioventricular block in 57%. Mean RDI was 18.9 events per hour. 234 (58%) of them had a mean RDI <20 and 170 (42%) had a mean RDI ≥20. Compared to patients with mean RDI<20, those with mean RDI ≥20 were youngers (78.6±10 years Vs 81.8±8 years; p=0.02), were more likely to be male (58.2% Vs 47.5%: p=0.035) and had more heart failure history (28.8% Vs 19.2%: p=0.03). BMI was not different between groups (26.3±5. vs 26.3±4; P=0.33). Mean follow-up was 27 months. Patients with RDI ≥20 had a mean Atrial fibrillation duration longer than patients with RDI <20 (631 min Vs 291 min respectively; p=0.014). RDI was correlated with FMS (r=0.26; p=0.0004). The stroke rate tended to be higher in the RDI ≥20 group (2.1% vs 5.4%) (p=0.12).
Conclusion
Severe SA detected by pacemaker was associated with longer AF duration. We did not find higher occurrence of stroke in the severe SA group.
Funding Acknowledgement
Type of funding source: None
Background
Pacemaker recipients are at high-risk of sleep apnea (SA). New generation of pacemakers allow day by day, sleep-disordered breathing (SDB) monitoring. These devices measure variations in thoracic impedance and can detect apnea and hypopnea.
Purpose
The aim was To compare the rate of SA detection in patients implanted with and without pacemaker capable of monitoring (SDB).
Methods
This retrospective study included all consecutive patients implanted with a pacemaker between 2013 and 2016 at Poitiers university hospital. Pacemaker recipients allowing SDB monitoring (SDB monitoring group) and pacemaker recipients not allowing SDB monitoring (control group) were compared in terms of SA diagnosis, continuous positive airway pressure (CPAP) therapy initiation, newly AF discovered and stroke occurrence.
Results
Among the 1442 patients included (mean age 79 years, 39% of women, BMI = 27 kg/m2). 653 were in the SDB monitoring group and 789 in the control group. The 2 groups were not different in terms of age, body mass index, cardiovascular risk factor, cardiac function, and medication. Indication for cardiac pacing was atrioventricular block and sinus dysfunction in 56% and 23% of patients respectively. Mean follow-up was 24.7 months. 40 patients (7.5%) have been diagnosed with SA in the SDB monitoring group and 18 (2.7%) in the control group (p<0.001). CPAP therapy was initiated in 33 (5%) patients in SDB monitoring group and in 16 (2%) patients for the control group (p=0.01). The rate of newly diagnosed AF was 15% in SDB monitoring and 7% in control group (p<0.001). The incidence of stroke was 16 (2.4%) in the SDB monitoring group and 18 (3.4%) in the control group (P=0.45).
Conclusion
In real life conditions, pacemakers capable of monitoring SDB improve the diagnosis of SA and CPAP therapy rate.
Monitoring of sleep apnea after at least
Funding Acknowledgement
Type of funding source: None
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