Severe sleep apnea is associated with atrial fibrillation burden in pacemaker recipients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Bidegain ◽  
B Degand ◽  
C Bouleti ◽  
L Christiaens ◽  
M Tavernier ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Impedance Measurement ◽  
Cardiac Pacing ◽  
University Hospital ◽  
Apnea Monitoring ◽  
History Of ◽  
Respiratory Disturbance ◽  
New Generation ◽  
Severe Sleep Apnea

Abstract Background New generation pacemaker allow the assessment day by day of sleep disordered breathing (SDB) based on impedance measurement. A recent study demonstrated that incidence of AF is higher in case of severe SA monitored by pacemaker Purpose The aim was to compare the atrial fibrillation (AF) burden between patients with severe and non-severe sleep apnea (SA) detected with pacemakers monitoring (SDB). Methods This retrospective study was carried out at our University Hospital. We included all patients with Microport CRM pacemaker implanted from 2013 to 2016 at our university hospital. Exclusion criteria were inactivation of sleep apnea monitoring (SAM), history of sleep apnea, missing data or invalid data. AF burden was assessed according to Fallback mode switch (FMS) duration. Respiratory disturbance index (RDI) was calculated as the average number of events (ventilation pause and reductions) per number of hours of monitoring. Patients with RDI<20/h were compared with patients with RDI≥20/h (considered as severe SA group). Results 404 patients (mean age = 79.7±10 years; 52.0% men) were included. The most prevalent indication for cardiac pacing was atrioventricular block in 57%. Mean RDI was 18.9 events per hour. 234 (58%) of them had a mean RDI <20 and 170 (42%) had a mean RDI ≥20. Compared to patients with mean RDI<20, those with mean RDI ≥20 were youngers (78.6±10 years Vs 81.8±8 years; p=0.02), were more likely to be male (58.2% Vs 47.5%: p=0.035) and had more heart failure history (28.8% Vs 19.2%: p=0.03). BMI was not different between groups (26.3±5. vs 26.3±4; P=0.33). Mean follow-up was 27 months. Patients with RDI ≥20 had a mean Atrial fibrillation duration longer than patients with RDI <20 (631 min Vs 291 min respectively; p=0.014). RDI was correlated with FMS (r=0.26; p=0.0004). The stroke rate tended to be higher in the RDI ≥20 group (2.1% vs 5.4%) (p=0.12). Conclusion Severe SA detected by pacemaker was associated with longer AF duration. We did not find higher occurrence of stroke in the severe SA group. Funding Acknowledgement Type of funding source: None

Extended Cardiac Monitoring in Patients with Severe Sleep Apnea and no History of Atrial Fibrillation (The Reveal XT-SA Study)

2018 ◽  
Vol 51 (6) ◽  
pp. 1166
Author(s):  
Cynthia Yeung ◽  
Doran Drew ◽  
Sharlene Hammond ◽  
Gwen Ewart ◽  
Damian Redfearn ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Cardiac Monitoring ◽  
History Of ◽  
Severe Sleep Apnea

scholarly journals EXTENDED CARDIAC MONITORING IN PATIENTS WITH SEVERE SLEEP APNEA AND NO HISTORY OF ATRIAL FIBRILLATION (THE REVEAL XT-SA STUDY)

2018 ◽  
Vol 71 (11) ◽  
pp. A517 ◽  
Author(s):  
Cynthia Yeung ◽  
Doran Drew ◽  
Sharlene Hammond ◽  
Gwen Ewart ◽  
Damian Redfearn ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Cardiac Monitoring ◽  
History Of ◽  
Severe Sleep Apnea

Extended Cardiac Monitoring in Patients With Severe Sleep Apnea and No History of Atrial Fibrillation (The Reveal XT-SA Study)

2018 ◽  
Vol 122 (11) ◽  
pp. 1885-1889 ◽  
Author(s):  
Cynthia Yeung ◽  
Doran Drew ◽  
Sharlene Hammond ◽  
Wilma M. Hopman ◽  
Damian Redfearn ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Cardiac Monitoring ◽  
History Of ◽  
Severe Sleep Apnea

scholarly journals The variability and burden of severe sleep apnea and the relationship with atrial fibrillation occurrence: analysis of pacemaker-detected sleep apnea

2021 ◽  
Author(s):  
RuoHan Chen ◽  
KePing Chen ◽  
Yan Dai ◽  
Shu Zhang
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Left Ventricular ◽  
The Mean ◽  
Respiratory Disturbance ◽  
A Prospective Study ◽  
The Relationship ◽  
Severe Sleep Apnea

Abstract Study objectives This was a pilot study to evaluate the long-term variability and burden of respiratory disturbance index (RDI) detected by pacemaker and to investigate the relationship between RDI and atrial fibrillation (AF) event in patients with pacemakers. Methods This was a prospective study enrolling patients implanted with a pacemaker that could calculate the night-to-night RDI. The mean follow-up was 348 ± 34 days. The RDI variability was defined as the standard deviation of RDI (RDI-SD). RDI burden was referred to as the percentage of nights with RDI ≥ 26. The patient with RDI ≥ 26 in more than 75% nights was considered to have a high sleep apnea (SA) burden. An AF event was defined as a daily AF duration > 6 h. Results Among 30 patients, the mean RDI of the whole follow-up period was 24.5 ± 8.6. Nine (30%) patients were diagnosed with high SA burden. Patients with high SA burden had a higher BMI (26.7 ± 4.8 vs 23.2 ± 3.9, p = 0.036), a higher prevalence of hypertension (86% vs 39%, p = 0.031), and a larger left ventricular diastolic diameter (49.2 mm vs 46.7 mm, p = 0.036). The RDI-SD in patients with a higher burden was significantly greater than that in the patients with less burden (10.7 ± 4.9 vs 5.7 ± 1.4, p = 0.036). Linear regression showed that participants with a higher RDI tended to have a higher SD (R = 0.661; p < 0.001). The mean RDI (OR = 1.118, 95%CI 1.008–1.244, p = 0.044) was associated with AF occurrence. Conclusion Using a metric such as burden of severe SA may be more appropriate to demonstrate a patient’s true disease burden.

Extended Cardiac Monitoring in Patients with Severe Sleep Apnea and no History of Atrial Fibrillation (The Reveal XT-SA Study)

2019 ◽  
Vol 53 ◽  
pp. e6
Author(s):  
Cynthia Yeung ◽  
Doran Drew ◽  
Sharlene Hammond ◽  
Gwen Ewart ◽  
Damian Redfearn ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Cardiac Monitoring ◽  
History Of ◽  
Severe Sleep Apnea

Comparison Of Drugs in Patients Using New Generation Anticoagulants

2021 ◽  
Vol 6 (14) ◽  
pp. 56-67
Author(s):  
Arslan Say ◽  
Abdülkadir ÇAKMAK ◽  
Gökhan KESKİN ◽  
Erdinç PELİT ◽  
Yılmaz ÖZBAY
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Venous Thromboembolism ◽  
Oral Anticoagulants ◽  
Recurrent Venous Thromboembolism ◽  
Anticoagulant Drugs ◽  
History Of ◽  
The Mean ◽  
N 93 ◽  
New Generation

Aim: New generation anticoagulants rapidly find a wider area of use in the clinic due to the use problems of other oral anticoagulants. Anticoagulants such as Dabigatran, Rivaroxaban, and Apixaban with safer treatment intervals have been accepted in clinical practice guidelines and have taken their place as preferred drugs. In this study, we aimed to retrospectively examine the effects of three new-generation anticoagulant drugs on a group of patients. Material and Methods: In this retrospectively planned study, patients diagnosed with atrial fibrillation (n = 522) were divided into three groups according to the drugs used for treatment (Dabigatran, Rivaroxaban, and Apixaban). Routine blood values of the patients in each group were retrospectively scanned according to age, gender, time of drug initiation and presence of chronic disease. Results: According to the results obtained, it was found that the mean HCT, BUN, AST, ALT, MPV, Iron, and Ferritin were higher in patients using Apixaban than those using Dabigatran and Rivaroxaban drugs, but the age, average values of Hgb1 Hgb2, Hgb1, PLT, CrCl, Gfr and INR of the patients using Apixaban lower than those using Dabigatran and Rivaroxaban. The highest rate (22.5%) was found in the group of patients taking apixaban (n=93) when people taking the drugs were examined in terms of mortality. Conclusion: It has been observed that Rivaroxaban can be used more safely in patients with a history of acute cancer and thrombosis, patients with recurrent venous thromboembolism, and patients with high frailty, three drugs should be preferred instead of oral anticoagulants.

Short Term Cardiac Monitoring of Patients with Severe Sleep Apnea does not Allow for the Prediction of Atrial Fibrillation

2018 ◽  
Vol 51 (6) ◽  
pp. 1166-1167
Author(s):  
Cynthia Yeung ◽  
Doran Drew ◽  
Sharlene Hammond ◽  
Gwen Ewart ◽  
Laiden Suarez-Fuster ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Cardiac Monitoring ◽  
Short Term ◽  
Severe Sleep Apnea

Pacemakers capable of monitoring sleep-disordered breathing: impact on sleep apnea detection in real life

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Bidegain ◽  
R Garcia ◽  
B Degand ◽  
L Christiaens ◽  
C Bouleti ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Real Life ◽  
Cardiac Pacing ◽  
University Hospital ◽  
Control Group ◽  
Cpap Therapy ◽  
Monitoring Group ◽  
Sinus Dysfunction ◽  
Disordered Breathing

Abstract Background Pacemaker recipients are at high-risk of sleep apnea (SA). New generation of pacemakers allow day by day, sleep-disordered breathing (SDB) monitoring. These devices measure variations in thoracic impedance and can detect apnea and hypopnea. Purpose The aim was To compare the rate of SA detection in patients implanted with and without pacemaker capable of monitoring (SDB). Methods This retrospective study included all consecutive patients implanted with a pacemaker between 2013 and 2016 at Poitiers university hospital. Pacemaker recipients allowing SDB monitoring (SDB monitoring group) and pacemaker recipients not allowing SDB monitoring (control group) were compared in terms of SA diagnosis, continuous positive airway pressure (CPAP) therapy initiation, newly AF discovered and stroke occurrence. Results Among the 1442 patients included (mean age 79 years, 39% of women, BMI = 27 kg/m2). 653 were in the SDB monitoring group and 789 in the control group. The 2 groups were not different in terms of age, body mass index, cardiovascular risk factor, cardiac function, and medication. Indication for cardiac pacing was atrioventricular block and sinus dysfunction in 56% and 23% of patients respectively. Mean follow-up was 24.7 months. 40 patients (7.5%) have been diagnosed with SA in the SDB monitoring group and 18 (2.7%) in the control group (p&lt;0.001). CPAP therapy was initiated in 33 (5%) patients in SDB monitoring group and in 16 (2%) patients for the control group (p=0.01). The rate of newly diagnosed AF was 15% in SDB monitoring and 7% in control group (p&lt;0.001). The incidence of stroke was 16 (2.4%) in the SDB monitoring group and 18 (3.4%) in the control group (P=0.45). Conclusion In real life conditions, pacemakers capable of monitoring SDB improve the diagnosis of SA and CPAP therapy rate. Monitoring of sleep apnea after at least Funding Acknowledgement Type of funding source: None

scholarly journals Pacemaker-detected severe sleep apnea predicts new-onset atrial fibrillation

EP Europace ◽  
2017 ◽  
Vol 19 (12) ◽  
pp. 1937-1943 ◽  
Author(s):  
Andrea Mazza ◽  
Maria Grazia Bendini ◽  
Raffaele De Cristofaro ◽  
Mariolina Lovecchio ◽  
Sergio Valsecchi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Onset Atrial Fibrillation ◽  
Severe Sleep Apnea ◽  
New Onset

Abstract 17143: Obstructive and Central Sleep Apnea and Risk of Incident Atrial Fibrillation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Patricia Tung ◽  
Yamini S Levitzky ◽  
Rui Wang ◽  
Stuart F Quan ◽  
Daniel J Gottlieb ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Health Study ◽  
Apnea Hypopnea Index ◽  
Community Based ◽  
Obstructive Sleep ◽  
History Of

INTRODUCTION: Prior studies have documented a higher prevalence of atrial fibrillation (AF) in those with obstructive sleep apnea (OSA). OSA has been associated with AF recurrence following cardioversion and ablation, and with prevalent and incident AF in cross-sectional and retrospective studies. Central sleep apnea (CSA) also has been associated with AF in patients with heart failure. However, data from prospective cohorts are sparse and few studies have evaluated the association of CSA with AF in population studies. METHODS: We assessed the association of OSA and CSA with incident AF among 3,420 subjects without a history of AF in the Sleep Heart Health Study (SHHS), a prospective, community-based study designed to evaluate the cardiovascular consequences of sleep disordered breathing. Subjects underwent overnight polysomnography at baseline and were followed over time for the development of incident AF, documented at any time after baseline polysomnogram until the end of follow-up. OSA was defined as an obstructive apnea-hypopnea index ≥ 5 and CSA was defined as a central apnea index ≥ 5. RESULTS: At baseline, the sample include 1499 men (44.4%) with a mean age of 62.4 (±10.9); 1569 (45.9%) subjects met criteria for mild to severe OSA and 54 (1.6%) for CSA. Over a mean follow-up of 8.2 years, 382 cases of incident AF were identified. The prevalence of both OSA and CSA was higher among those who developed AF compared to those who did not (OSA 49% vs 44%, p=0.001 and CSA 5% vs 1.2%, p=0.001). After adjustment for multiple AF risk factors, CSA was associated with an approximately 2-fold increased odds of incident AF (RR=2.38, 95% CI, 1.15-4.94; p = 0.02). The association persisted after exclusion of 258 subjects with a history of heart failure (RR=2.78, 95% CI, 1.28-6.04; p = 0.01). We did not find a significant association of OSA with incident AF (Table). CONCLUSION: In our prospective, community-based cohort baseline CSA was associated with incident AF.

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