• Yuka Taguchi, Kohei Matsushita, Toshiyuki Ishikawa, Katsumi Matsumoto, Junya Hosoda, Kouhei Iguchi, Hirooki Matsushita, Kazumi Kubota, Shinnichi Sumita, Tomoaki Ishigami, and Kouichi Tamura.
• Yokohama City University Graduate School of Medicine, Department of Medical Science and Cardio-renal Medicine, Yokohama, Japan.
• J Cardiol. 2019 May 1; 73 (5): 394-400.

BackgroundRecent pacemakers with transthoracic impedance sensors have a specific algorithm identifying sleep apnea (SA). Our aim was to evaluate the algorithm in Japanese patients.MethodsConsecutive patients implanted with a pacemaker with sleep apnea monitoring algorithm at our hospital were enrolled prospectively. After implantation, patients underwent polysomnography (PSG). The respiratory disturbance index measured by pacemaker (RDI-PM) was extracted in the morning after PSG.ResultsForty-five patients were recruited; 78% of patients underwent overnight PSG completely, and among them RDI-PM was invalid for one patient. Then the analysis was performed in 34 patients. Moderate/severe SA (apnea hypopnea index, AHI≥15events/h) and severe SA (AHI≥30events/h) by PSG were diagnosed in 65% and 41% of patients. The mean AHI-PSG and RDI-PM were 30.4±22.6 and 21.7±14.2events/h, respectively. There was a significant positive correlation between AHI-PSG and RDI-PM (r=0.543; p=0.001). The correlation was stronger in the severe SA group (r=0.664; p=0.010), in a group whose apnea index was higher than hypopnea index (r=0.822; p=0.002), and in a group whose central sleep apnea (CSA) index was higher than obstructive sleep apnea index (r=0.977; p<0.001). RDI-PM cut-off value for identifying severe SA was 22 (area under the curve, 0.682; sensitivity, 64%; specificity, 75%).ConclusionsThe pacemaker-based algorithm is a useful screening tool for SA in Japanese individuals, especially in the severe SA group, apnea-dominant group, and CSA-dominant group.Copyright © 2018. Published by Elsevier Ltd.

16 keywords...

hide…