Occurrence of atrial fibrillation in pacemaker patients and its association with sleep apnea and heart rate variability

Mazza, Andrea; Bendini, Maria Grazia; Valsecchi, Sergio; Lovecchio, Mariolina; Leggio, Massimo; Cristofaro, Raffaele De; Boriani, Giuseppe

doi:10.1016/j.ejim.2019.07.020

Cited by 5 publications

(5 citation statements)

References 31 publications

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“…Atrial fibrillation is common in patients with pacemakers, 28 and devices frequently detect silent episodes in patients without a clinical history of AF 29 . Our findings that severe SA was independently predictive of AF occurrence extends to the specific field of device‐detected subclinical AF, and confirm previous smaller studies 14,30,31 . Our results suggest that device‐based RDI may be helpful in stratifying pacemaker patients for AF risk, by reviewing these automated diagnostic data during routine in‐office or remote interrogation.…”

Section: Discussionsupporting

confidence: 83%

“…29 Our findings that severe SA was independently predictive of AF occurrence extends to the specific field of device-detected subclinical AF, and confirm previous smaller studies. 14,30,31 Our results suggest that device-based RDI may be helpful in stratifying pacemaker patients for AF risk, by reviewing these automated diagnostic data during routine in-office or remote interrogation. Indeed, the risk of AF was almost doubled in patients with SA diagnosed by the device during follow-up.…”

Section: Discussionmentioning

confidence: 86%

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Continuous monitoring of sleep‐disordered breathing with pacemakers: Indexes for risk stratification of atrial fibrillation and risk of stroke

Mazza¹,

Bendini²,

Leggio

et al. 2020

Clinical Cardiology

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Background: Sleep apnea (SA) is a risk factor for atrial fibrillation (AF). Advanced pacemakers are now able to calculate indexes of SA severity. Hypothesis: We investigated the changes in pacemaker-measured indexes of SA, we assessed their predictive value for AF occurrence and the associated risk of stroke and death at long-term. Methods: We enrolled 439 recipients of a pacemaker endowed with an algorithm for the calculation of a Respiratory Disturbance Index (RDI). The RDI variability was measured over the first 12 months after implantation, as well as its potential association with the occurrence of AF, defined as device-detected cumulative AF burden ≥6 hoursours in a day. Results: The individual RDI mean was 30 ± 18 episodes/h, and the RDI maximum was 59 ± 21 episodes/h. RDI ≥30 episodes/h was detected in 351 (80%) patients during at least one night. The proportion of nights with RDI ≥30 episodes/h was 14% (2%-36%). AF ≥6 hours was detected in 129 (29%) patients during the first 12 months. The risk of AF was higher in patients with RDI maximum ≥63 episodes/h

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 86%

Continuous monitoring of sleep‐disordered breathing with pacemakers: Indexes for risk stratification of atrial fibrillation and risk of stroke

Mazza¹,

Bendini²,

Leggio

et al. 2020

Clinical Cardiology

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“…Sleep-disordered breathing is frequent in heart failure (HF) 1 and has been associated with the development of arrhythmias. [2][3][4] Multiple factors such as hypoxemia, sympathetic activation, and systemic inflammation that occur in obstructive sleep apnea (SA) may also be mechanisms that predispose to the development of AF. Indeed, a higher proportion of patients with a history of AF have been shown to have obstructive SA in comparison with the general population.…”

Section: Discussionmentioning

confidence: 99%

“…Sleep‐disordered breathing is frequent in heart failure (HF) 1 and has been associated with the development of arrhythmias 2–4 . Multiple factors such as hypoxemia, sympathetic activation, and systemic inflammation that occur in obstructive sleep apnea (SA) may also be mechanisms that predispose to the development of AF.…”

Section: Introductionmentioning

confidence: 99%

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

Boriani

Diemberger

Pisanò

et al. 2022

Cardiovasc electrophysiol

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Introduction:The Respiratory Disturbance Index (RDI) computed by an implantable cardioverter defibrillator (ICD) algorithm accurately identifies severe sleep apnea (SA). In the present analysis, we tested the hypothesis that RDI could also predict atrial fibrillation (AF) burden.Methods: Patients with ejection fraction ≤35% implanted with an ICD were enrolled and followed up for 24 months. One month after implantation, patients

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“…Since appropriate prescription of oral anticoagulants in patients at risk of stroke is a major determinant of outcome at long term [34][35][36][37][38][39][40], it will be necessary in the near future to establish even stricter connections between hospital and out of hospital care, for a re-assessment of patients who presented AF and these months with regard to clinical evaluation and appropriateness of treatment for ensuring continuity of care. It will also be interesting to assess to what extent untreated or undiscovered AF occurred during the lockdown will result in major consequences, such as syncope, heart failure, stroke/systemic embolism [41][42][43].…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Boriani

Palmisano²,

Guerra

et al. 2020

Intern Emerg Med

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COVID-19 outbreak had a major impact on the organization of care in Italy, and a survey to evaluate provision of for arrhythmia during COVID-19 outbreak (March-April 2020) was launched. A total of 104 physicians from 84 Italian arrhythmia centres took part in the survey. The vast majority of participating centres (95.2%) reported a significant reduction in the number of elective pacemaker implantations during the outbreak period compared to the corresponding two months of year 2019 (50.0% of centres reported a reduction of > 50%). Similarly, 92.9% of participating centres reported a significant reduction in the number of implantable cardioverter-defibrillator (ICD) implantations for primary prevention, and 72.6% a significant reduction of ICD implantations for secondary prevention (> 50% in 65.5 and 44.0% of the centres, respectively). The majority of participating centres (77.4%) reported a significant reduction in the number of elective ablations (> 50% in 65.5% of the centres). Also the interventional procedures performed in an emergency setting, as well as acute management of atrial fibrillation had a marked reduction, thus leading to the conclusion that the impact of COVID-19 was disrupting the entire organization of health care, with a massive impact on the activities and procedures related to arrhythmia management in Italy.

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Occurrence of atrial fibrillation in pacemaker patients and its association with sleep apnea and heart rate variability

Cited by 5 publications

References 31 publications

Continuous monitoring of sleep‐disordered breathing with pacemakers: Indexes for risk stratification of atrial fibrillation and risk of stroke

Continuous monitoring of sleep‐disordered breathing with pacemakers: Indexes for risk stratification of atrial fibrillation and risk of stroke

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

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

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