Usefulness of sleep apnea monitoring by pacemaker sensor in elderly patients with diastolic dysfunction - 19/09/23
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Highlights |
• | RDI is well correlated with AHI in octogenarian patients with diastolic dysfunction. |
• | RDI cutoff value to detect severe SA is >20. |
• | Moderate to severe SA is suspected if RDI is between 15 and 20. |
• | RDI could represent a suitable tool to monitor patients treated by CPAP. |
Abstract |
Background |
Automated detection of sleep apnea (SA) by pacemaker (PM) has been proposed and exhibited good agreement with polysomnography to detect severe SA. We aimed to evaluate the usefulness of SA monitoring algorithm in elderly patients with diastolic dysfunction.
Methods |
Consecutive patients referred to the Caen University Hospital for PM implantation between May 2016 and December 2018 presenting isolated diastolic dysfunction were eligible for the study. The respiratory disturbance index (RDI) measured by the PM, and the mean monthly RDI (RDIm), were compared to the apnea hypopnea index (AHI) assessed with portable monitor for severe SA diagnosis.
Results |
During the study period, 68 patients were recruited, aged of 80.4 ± 8.2 years. 63 patients underwent polygraphy with a portable monitor: 57 presented SA (83.8%), including 16 with severe SA (23.5%). Eight were treated with continuous positive airway pressure (CPAP). We found the RDI cutoff value of 22 events/h to predict severe SA, with 71.4% sensitivity and 65.2%, specificity. The RDIm cutoff value to detect severe SA was 19 events/h, with a sensitivity of 60% and a specificity of 66%. There was a significant reduction in RDI (p = 0.041), RDIm (p = 0.039) and AHI (p = 0.002) after CPAP. Supraventricular arrhythmias were frequent in all patients, regardless of SA severity, considering either episodes occurrence or total burden.
Conclusion |
In a population of elderly patients with PM and diastolic dysfunction, the SA monitoring algorithm was able to detect severe SA, with good diagnostic performance values, but also to provide follow-up data for the patients treated with CPAP.
Le texte complet de cet article est disponible en PDF.Keywords : Sleep apnea, Pacemaker, Apnea hypopnea index, Respiratory disturbance index, Continuous positive airway pressure
Abbreviations : AF, AHI, AUC, CPAP, DD, HFpEF, PG, PM, PSG, RDI, RDIm, ROC, SA, SAM
Plan
Vol 84
Article 101025- novembre 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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