Association between implantable defibrillator‐detected sleep apnea and atrial fibrillation: The DASAP‐HF study

Boriani, Giuseppe; Diemberger, Igor; Pisanò, E; Pieragnoli, Paolo; Locatelli, Alessandro; Capucci, Alessandro; Talarico, Antonello; Zecchin, Massimo; Rapacciuolo, Antonio; Piacenti, Marcello; Indolfi, Ciro; Arias, Miguel Á.; Checchinato, Catia; Rovere, Maria Teresa La; Sinagra, Gianfranco; Emdin, Michele; Ricci, Renato Pietro; D’Onofrio, Antonio

doi:10.1111/jce.15506

Cited by 3 publications

(8 citation statements)

References 48 publications

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“…We screened subjects with pacemakers or AICD for the risk of OSA using the Berlin Questionnaire and compared the incidence of ventricular arrhythmia and AICD firing between the high and low OSA risk groups over a 2-year period. We found that, similar to prior studies, 52.1% of the study population and 61.1% of the ACID subgroup had a high risk of OSA using the Berlin Questionnaire [1,2,11]. Adjusting for age, gender and a diagnosis of heart failure, we found significantly more NSVT among patients in the high OSA risk category.…”

Section: Discussionsupporting

confidence: 88%

“…The European Multicenter Polysomnographic Study showed that 59% of patients with long-term pacing had OSA on polysomnography [13]. Other studies demonstrated a similarly high incidence of OSA among pacemaker and AICD recipients, ranging from 40-66% [11,[23][24][25][26][27][28][29]. In a study of patients with ejection fractions less than 35%, and with AICD similar to data from our study, there were no significant ventricular arrhythmias or worsening of heart failure; however, there was a slightly increased incidence of atrial fibrillation [11].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, a study of patients with hypertrophic obstructive cardiomyopathy showed that the presence of OSA was associated with NSVT [9]. In patients with heart failure, sleep apnea was associated with atrial fibrillation in the DASAP-HF study [11]. The association of OSA with ventricular arrhythmias is less clear, although treatment of sleep apnea has been associated with a decreased risk of ventricular arrhythmias [10].…”

Section: Discussionmentioning

confidence: 99%

“…Association studies have shown a link between OSA and ventricular and supraventricular arrhythmias [3,8,9,11,12,21,22]. Patients with untreated OSA undergoing ablation for atrial fibrillation have higher rates of recurrence compared with those on appropriate CPAP therapy [21].…”

Section: Discussionmentioning

confidence: 99%

“…Obstructive sleep apnea (OSA) affects up to 24% of men and 9% of women [1][2][3] and has been associated with an increased risk of cardiovascular disease as well as mortality [3][4][5]. Patients with OSA have a higher incidence of a variety of arrhythmias [6][7][8][9][10][11][12][13]. We wanted to better understand the association between the risk of OSA and ventricular arrhythmias so we classified patients with pre-existing cardiovascular disease in our arrhythmia clinic into high or low risk of OSA groups using the Berlin Questionnaire to compare the prevalence of ventricular arrhythmias and automatic implantable cardioverter defibrillator (AICD) firings between the two risk groups.…”

Section: Introductionmentioning

confidence: 99%

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Ventricular Arrhythmias in Patients with Implanted Cardiac Devices at High Risk of Obstructive Sleep Apnea

et al. 2022

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Background and Objectives: Patients with pre-existing cardiac disease have a higher prevalence of Obstructive Sleep Apnea (OSA). OSA has been associated with an increased risk of supraventricular and ventricular arrhythmia. We screened subjects with implanted pacemakers and automated implantable cardioverter defibrillators (AICD) for OSA with the Berlin Questionnaire and compared the incidence of ventricular arrhythmias and automated implantable cardioverter defibrillator (AICD) firing between high and low OSA risk groups. Materials and Methods: We contacted 648 consecutive patients from our arrhythmia clinic to participate in the study and performed final analyses on 171 subjects who consented and had follow-up data. Data were abstracted from the electronic health record for the incidence of non-sustained ventricular tachycardia (NSVT), ventricular tachycardia (VT), ventricular fibrillation (VF) and AICD firing and then compared between those at high versus low risk of OSA using the Berlin Questionnaire and multivariate negative binomial regression. Results: The average follow-up period was 24.2 ± 4.4 months. After adjusting for age, gender and history of heart failure, those subjects at high risk of OSA had a higher burden of NSVT vs. those with a low risk of OSA (33.4 ± 96.2 vs. 5.82 ± 17.1 episodes, p = 0.003). A predetermined subgroup analysis of AICD recipients also demonstrated a significantly higher burden of NSVT in the high vs. low OSA risk groups (66.2 ± 128.6 vs. 18.9 ± 36.7 episodes, p = 0.033). There were significant differences in the rates of VT, VF or AICD shock burden between the high and low OSA risk groups and in the AICD subgroup analysis. Conclusions: There was increased ventricular ectopy among pacemaker and AICD recipients at high risk of OSA, but the prevalence of VT, VF or AICD shocks was similar to those with low risk of OSA.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ventricular Arrhythmias in Patients with Implanted Cardiac Devices at High Risk of Obstructive Sleep Apnea

et al. 2022

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Vagal milieu or electrophysiologic substrate? The link between atrial fibrillation and obstructive sleep apnea

Ifedili

Ingram

Blount

et al. 2022

Exp Biol Med (Maywood)

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Atrial fibrillation is the most common cardiac arrhythmia with its prevalence expected to increase to 12.1 million people in the United States by 2030. Chronic underlying conditions that affect the heart and lungs predispose patients to develop atrial fibrillation. Obstructive sleep apnea is strongly associated with atrial fibrillation. Several pathophysiological mechanisms have been proposed to elucidate this relationship which includes electrophysiological substrate modification and the contribution of the autonomic nervous system. In this comprehensive review, we highlight important relationships and plausible causality between obstructive sleep apnea and atrial fibrillation which will improve our understanding in the evaluation, management, and prevention of atrial fibrillation. This is the most updated comprehensive review of the relationship between obstructive sleep apnea and atrial fibrillation.

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Protocolo de actuación para la prevención de la descompensación de la insuficiencia cardiaca mediante el uso del algoritmo heart logic

Aroca Fernandez,

Benavent Vallejo,

Buigues González

et al. 2024

Enferm Cardiol

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Introducción y objetivos. La insuficiencia cardiaca supone un desafío sociosanitario por su gran prevalencia y gravedad clínica. Por ello, se ha planteado la necesidad de la detección temprana de la descompensación en insuficiencia cardiaca mediante la alerta que generan los novedosos sensores HeartLogic e «inclinación del sueño» incorporados a los desfibriladores implantables. Nuestro objetivo es realizar un protocolo de actuación clínico y el análisis posterior de las alertas generadas y los eventos clínicos. Material y Métodos. Se trata de un estudio uni centro, observacional, longitudinal y prospectivo. El seguimiento de estos pacientes es llevado a cabo mediante consultas realizadas por el personal de enfermería de las unidades de electrofisiología e insuficiencia cardiaca. El protocolo consiste en la actuación asistencial y el seguimiento de los pacientes portadores de desfibriladores con los sensores comentados, los cuales generan una alerta de descompensación que envían mediante consulta telemática al personal sanitario. Una vez se genera dicha alerta, el paciente es citado para realizarse una analítica de control y una consulta presencial para la detección de eventos clínicos. Discusión. La finalidad es evitar hospitalizaciones o visitas a urgencias en dichos pacientes sin aumentar en exceso la carga de trabajo al personal. También se evaluará la asociación entre el número de alertas y los eventos clínicos (alertas reales o inexplicables). Hasta la fecha, ha supuesto una actuación precoz consiguiendo solventar los problemas potenciales detectados antes de que ocurra un empeoramiento de la situación clínica con una baja tasa de alertas inexplicables. Palabras clave: Insuficiencia cardiaca, HeartLogic, Desfibriladores implantables, sueño.

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Association between implantable defibrillator‐detected sleep apnea and atrial fibrillation: The DASAP‐HF study

Cited by 3 publications

References 48 publications

Ventricular Arrhythmias in Patients with Implanted Cardiac Devices at High Risk of Obstructive Sleep Apnea

Ventricular Arrhythmias in Patients with Implanted Cardiac Devices at High Risk of Obstructive Sleep Apnea

Vagal milieu or electrophysiologic substrate? The link between atrial fibrillation and obstructive sleep apnea

Protocolo de actuación para la prevención de la descompensación de la insuficiencia cardiaca mediante el uso del algoritmo heart logic

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