Accuracy and utility of a pacemaker respiratory monitoring algorithm for the detection of obstructive sleep apnea in patients with atrial fibrillation

• Published in: Sleep medicine 2019-09, Vol.61, p.88-94
• Main Authors: Gonçalves, Inês S., Agostinho, João R., Silva, Gustavo, Guimarães, Tatiana, Bernardes, Ana, Santos, Igor, Pinto, Paula, Bárbara, Cristina, de Sousa, João, Pinto, Fausto J., Marques, Pedro
• Format: Article
• Language: English
• Subjects: Atrial fibrillation; Obstructive sleep apnea syndrome; Pacemaker; Sleep apnea monitoring
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2019.01.051

The usefulness and diagnostic value of new-generation pacemakers (PM) with enhanced monitoring capabilities are not yet clearly established. The aim of this study was to evaluate the diagnostic utility and accuracy of a PM-incorporated respiratory monitoring algorithm and its interaction with atrial fibrillation (AF). A single-center prospective study was performed in consecutive patients who underwent PM implantation featuring a respiratory monitoring algorithm. All patients had polysomnography recording. The respiratory disturbance index of the polysomnography and pacemaker (RDI-PM) were recorded on the same night. Occurrence and burden of AF were also recorded. The diagnostic utility of RDI-PM and its interaction with AF were evaluated. A total of 81 patients were included (age 73 ± 11 years). Obstructive sleep apnea syndrome (OSAS) was diagnosed in 62%. RDI-PM had good diagnostic accuracy for OSAS (area under the curve: 0.767 [95% CI: 0.65–0.88]; p