Long-term Screening for Sleep Apnoea in Paced Patients: Preliminary Assessment of a Novel Patient Management Flowchart by Using Automatic Pacemaker Indexes and Sleep Lab Polygraphy

Rationale and Design for a Monocentric Prospective Study: Sleep Apnea Diagnosis Using a Novel Pacemaker Algorithm and Link With Aldosterone Plasma Level in Patients Presenting With Diastolic Dysfunction (SAPAAD Study)

“…The SAM algorithm developed by LivaNova is a new screening tool for SA diagnosis. There are several data on its accuracy 13 , 14 , 17 , 19 and a prospective study already showed that the RDI was well correlated with PSG. 14 The interest of our study is to validate the diagnostic accuracy of the SAM algorithm within a particular subgroup of patients.…”

“…This feature may compensate the weakness of a single-signal recording by the SAM algorithm compared with ACSS result based on several signals. Aimé et al 17 suggested already that a “smoothed” index should be more sensitive to detect SA. Finally, the decrease of the RDI, compared to the AHI, after CPAP treatment will also test the agreement between these 2 values.…”

“…Two were performed with PM that did not allow automatic treatment of the transthoracic impedance 15,16 and the signal was processed and analyzed using a dedicated software. All studies [13][14][15][16][17][18] except one 19 used PSG as reference test but with different AHI threshold values according to SA severity required for diagnosis. Designs were different and therefore diagnostic accuracy statistics are difficult to compare.…”

“…Padeletti et al 19 did not report if patients were correctly classified for SA based on PM index but only correlation between mean values of AHI from PM and in-home respiratory monitoring. In the study by Aimé et al, 17 only apneic patients based on PM index (40/61 patients, 65.6%) were proposed to undergo PSG. Only 65% of them realized the reference test and the positive predictive value of PM index could be overestimated.…”

“…There was a good correlation between these indexes and, moreover, the smoothed index had a better sensitivity to detect SA than the short-term index. 17 Among these studies, only 1 reported data about arrhythmias. The incidence of AF or other rhythm disorders was similar in patients with and without SA, based on in-home respiratory monitoring (AHI ≥ 10/h).…”