Aime, Ezio and Rovida, Marina and Contardi, Danilo and Ricci, Cristian and Gaeta, Maddalena and Innocenti, Ester and Tantchou-Tchoumi, Jacques Cabral (2014) 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. HEART LUNG AND CIRCULATION, 23 (10). pp. 943-950. ISSN 1443-9506, 1444-2892
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Background The primary aim of this pilot study was to prospectively assess a flowchart to screen and diagnose paced patients (pts) affected by sleep apnoeas, by crosschecking indexes derived from pacemakers (minute ventilation sensor on-board) with Sleep-Lab Polygraphy (PG) outcomes. Secondarily, "smoothed" long-term pacemaker indexes (all the information between two consecutive follow-up visits) have been retrospectively compared vs. standard short-term pacemaker indexes (last 24 h) at each follow-up (FU) visit, to test their correlation and diagnostic concordance. Methods Data from long-term FU of 61 paced pts were collected. At each visit, the standard short-term apnoea+hypopnoea (PM_AHI) index was retrieved from the pacemaker memory. Patients showing PM_AHI >= 30 at least once during FU were proposed to undergo a PG for diagnostic confirmation. Smoothed pacemaker (PM_SAHI) indexes were calculated by averaging the overall number of apnoeas/hypopnoeas over the period between two FU visits, and retrospectively compared with standard PM_AHI. Results Data were available from 609 consecutive visits (overall 4.64 +/- 1.78 years FU). PM_AHI indexes were positive during FU in 40/61 pts (65.6%); 26/40 pts (65%) accepted to undergo a PG recording; Sleep-Lab confirmed positivity in 22/26 pts (84.6% positive predictive value for PM_AHI). A strong correlation (r=0.73) and a high level of concordance were found between smoothed and standard indexes (multivariate analysis, Cohen's-k and Z-score tests). Conclusions Pacemaker-derived indexes may help in screening paced pts potentially affected by sleep apnoeas. Longterm "smoothed" apnoea indexes could improve the accuracy of pacemaker screening capability, even though this hypothesis must be prospectively confirmed by larger studies.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TRANSTHORACIC IMPEDANCE SENSOR; HYPOPNEA SYNDROME; NASAL PRESSURE; DIAGNOSIS; OXIMETRY; POLYSOMNOGRAPHY; RECIPIENTS; HOME; Artificial pacemaker; Sleep apnoea; Polysomnography; Apnoea and hypopnoea index; Screening; Minute ventilation sensor |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Institut für Epidemiologie und Präventivmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Aug 2019 13:29 |
| Last Modified: | 12 Aug 2019 13:29 |
| URI: | https://pred.uni-regensburg.de/id/eprint/9439 |
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