Publicação
Utility of new-generation pacemakers in sleep apnea screening
| dc.contributor.author | Dias, Margarida | |
| dc.contributor.author | Gonçalves, Inês | |
| dc.contributor.author | Amann, Bruno | |
| dc.contributor.author | Marques, Pedro | |
| dc.contributor.author | Martinho, Cristina | |
| dc.contributor.author | Leitão, Catarina | |
| dc.contributor.author | Basto, Rita Pinto | |
| dc.contributor.author | Sousa, João de | |
| dc.contributor.author | Pinto, Paula | |
| dc.contributor.author | Bárbara, Cristina | |
| dc.date.accessioned | 2017-09-18T15:32:48Z | |
| dc.date.available | 2017-09-18T15:32:48Z | |
| dc.date.issued | 2017 | |
| dc.description | © 2017 Elsevier B.V. All rights reserved. | pt_PT |
| dc.description.abstract | Objective: Patients with cardiac pacemakers present a high prevalence of undiagnosed sleep apnea syndrome (SAS). New-generation pacemakers have algorithms that identify sleep respiratory events. Our aim was to evaluate their accuracy in the diagnosis of SAS. Methods: We performed a prospective study that included patients with new-generation pacemakers (Reply 200 pacemakers). All patients underwent a polysomnography (PSG). On the same night, the respiratory disturbance index of the PSG (RDI-PSG) and of the pacemaker (RDI-PM) were recorded. The agreement between methods was assessed using the kappa coefficient, Bland and Altman statistics and receiver operating characteristic (ROC) curves. Results: Sixty patients were recruited but the RDI-PM for the PSG night was not available in six patients. PSG diagnosed SAS in 74% of patients (20% severe, 19% moderate, 35% mild). Besides snoring (63%), most patients had no SAS symptoms. There was a strong positive correlation between RDI-PSG and RDI-PM (r ¼ 0.522, p < 0.001), but the level of agreement between methods regarding SA diagnosis/severity was poor (k ¼ 0.167). ROC curves identified a RDI-PM of 10 events/h as the optimal cut-off point for diagnosing SAS (area under the curve (AUC): 0.81, sensitivity: 80%, specificity: 79%, positive predictive value: 91%, negative predictive value: 58%). The best cut-off for identifying moderate/severe SAS was at 13 events/h (AUC: 0.86, sensitivity: 100%, specificity: 70%, positive predictive value: 68%, negative predictive value: 100%). Conclusions: SAS prevalence in patients with pacemakers is high (74%). Most are asymptomatic, which could delay the diagnosis. Patients with clinical indication for a pacemaker may benefit from a device with sleep apnea monitoring. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Sleep Medicine 37 (2017) 27-31 | pt_PT |
| dc.identifier.doi | 10.1016/j.sleep.2017.06.006 | pt_PT |
| dc.identifier.issn | 1389-9457 | |
| dc.identifier.uri | http://hdl.handle.net/10451/28955 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier | pt_PT |
| dc.relation.publisherversion | https://www.journals.elsevier.com/sleep-medicine/ | pt_PT |
| dc.subject | Sleep apnea syndrome | pt_PT |
| dc.subject | Cardiac pacemaker | pt_PT |
| dc.subject | Polysomnography | pt_PT |
| dc.title | Utility of new-generation pacemakers in sleep apnea screening | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 31 | pt_PT |
| oaire.citation.startPage | 27 | pt_PT |
| oaire.citation.title | Sleep Medicine | pt_PT |
| oaire.citation.volume | 37 | pt_PT |
| rcaap.rights | restrictedAccess | pt_PT |
| rcaap.type | article | pt_PT |