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

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dc.contributor.authorGonçalves, Inês S.
dc.contributor.authorAgostinho, João R.
dc.contributor.authorSilva, Gustavo
dc.contributor.authorGuimarães, Tatiana Isabel Oliveira
dc.contributor.authorBernardes, Ana
dc.contributor.authorSantos, Igor
dc.contributor.authorPinto, Paula
dc.contributor.authorBárbara, Cristina
dc.contributor.authorSousa, João de
dc.contributor.authorPinto, Fausto J.
dc.contributor.authorMarques, Pedro
dc.date.accessioned2019-09-03T13:12:20Z
dc.date.available2019-09-03T13:12:20Z
dc.date.issued2019
dc.description© 2019 Elsevier B.V. All rights reserved.pt_PT
dc.description.abstractIntroduction: 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). Methods: 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. Results: 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: 0.65e0.88]; p < 0.001), with an ideal diagnostic cut-off of 13.3 (sensitivity 78%; specificity 78%) and 90% sensitivity for the diagnosis of moderate-to-severe OSAS. Time to AF first episode and total AF burden were not significantly different between patients with and without OSAS. However, in those whose OSAS diagnosis was based on RDI-PM, there was a significantly greater AF burden in patients with vs without OSAS (cut-off 13, 488 vs 83 min, p ¼ 0.05). In patients with AF, the RDI-PM cut-off of 13.3 decreased specificity (57%) vs the general population, but in patients without AF the specificity was 100% and sensitivity 77%. Conclusion: OSAS was prevalent in PM patients. RDI-PM diagnosed OSAS accurately, with high sensitivity for the detection of moderate-to-severe OSAS, making it a suitable screening method. AF, however, significantly decreased the specificity of RDI-PM for OSAS diagnosis.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSleep Med. 2019 Mar 7. pii: S1389-9457(18)30834-7pt_PT
dc.identifier.doi10.1016/j.sleep.2019.01.051pt_PT
dc.identifier.issn1389-9457
dc.identifier.urihttp://hdl.handle.net/10451/39421
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/sleep-medicinept_PT
dc.subjectObstructive sleep apnea syndromept_PT
dc.subjectSleep apnea monitoringpt_PT
dc.subjectPacemakerpt_PT
dc.subjectAtrial fibrillationpt_PT
dc.titleAccuracy and utility of a pacemaker respiratory monitoring algorithm for the detection of obstructive sleep apnea in patients with atrial fibrillationpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage94pt_PT
oaire.citation.startPage88pt_PT
oaire.citation.titleSleep Medicinept_PT
oaire.citation.volume61pt_PT
person.familyNameRibeiro Agostinho
person.familyNamePinto
person.givenNameJoão Pedro
person.givenNameFausto J.
person.identifier1308889
person.identifier.ciencia-idC311-AEDD-6DBB
person.identifier.orcid0000-0002-4778-5066
person.identifier.orcid0000-0002-8034-4529
person.identifier.ridG-9363-2015
person.identifier.scopus-author-id7102740158
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication778547ca-51a0-46a0-9af2-30998f6ac95d
relation.isAuthorOfPublication5f44176f-69f5-482c-83cd-ab94425a6ec3
relation.isAuthorOfPublication.latestForDiscovery5f44176f-69f5-482c-83cd-ab94425a6ec3

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