Article Dans Une Revue Heart Rhythm Année : 2020

Incidence of sleep apnea and association with atrial fibrillation in an unselected pacemaker population: Results of the observational RESPIRE study

Julio Marti-Almor
  • Fonction : Auteur
Pedro Marques
  • Fonction : Auteur
Laurence Jesel
Rodrigue Garcia
Enrico Di Girolamo
  • Fonction : Auteur
Fabio Locati
  • Fonction : Auteur
Pascal Defaye
  • Fonction : Auteur
Paul Venables
  • Fonction : Auteur
Antoine Dompnier
  • Fonction : Auteur
Aina Barcelo
  • Fonction : Auteur
Herbert Nägele
  • Fonction : Auteur
Haran Burri
  • Fonction : Auteur

Résumé

BACKGROUND: Patients with atrial fibrillation (AF) often have sleep apnea (SA), but diagnosis of SA with polysomnography is costly. SA monitoring is a pacemaker feature that measures respiratory disturbance index, the sum of abnormal respiratory events divided by sleep duration. OBJECTIVE: The purpose of this study was to evaluate the incidence and severity of SA and its association with AF in an unselected population fitted with pacemakers. METHODS: RESPIRE (REgistry of Sleep APnea monItoring and Atrial Fibrillation in pacemakeR patients) was a multicenter, international, observational, open-label study following adult subjects for 18 months after implantation with an SA monitoring-enabled dual-chamber pacemaker. Severe SA was defined as average respiratory disturbance index ≥20 from implantation to follow-up visit. The first co-primary end point was the difference in significant AF (cumulative AF episodes lasting ≥24 hours over 2 consecutive days) between subjects with severe and those nonsevere SA at 12 months in the full analysis set (N = 553). The second co-primary end point was the rate of major serious adverse events at 18 months in the modified intention-to-treat set (N = 1024). RESULTS: Severe SA was detected in 31.1% (172 of 553). A higher incidence of significant AF was reported in patients with severe SA than in patients with nonsevere SA (25.0% vs 13.9%; difference 11.1%; 95% confidence interval 3.7%-18.4%; P = .002). Significant AF increased with time in both groups, but at a faster rate in the severe SA group. No intergroup difference in the overall rate of major serious adverse events was observed (P = .065). CONCLUSION: SA screening over 12 months identified severe SA in almost one-third of unselected patients fitted with pacemakers. Severe SA was associated with a higher incidence of significant AF.

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hal-03944279 , version 1 (17-01-2023)

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Julio Marti-Almor, Pedro Marques, Laurence Jesel, Rodrigue Garcia, Enrico Di Girolamo, et al.. Incidence of sleep apnea and association with atrial fibrillation in an unselected pacemaker population: Results of the observational RESPIRE study. Heart Rhythm, 2020, 17 (2), pp.195-202. ⟨10.1016/j.hrthm.2019.09.001⟩. ⟨hal-03944279⟩
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