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Overdrive atrial pacing does not improve obstructive sleep apnoea syndrome
J-L Pépin1, P Defaye, S Garrigue
1Sleep Laboratory, Joseph Fourier University, Grenoble, France. JPepin@chu-grenoble.fr
The European Respiratory Journal
|February 3, 2005
Summary
Atrial overdrive pacing did not significantly improve obstructive sleep apnoea (OSAS) severity in patients with pacemakers. This study found no changes in respiratory or sleep parameters with pacing.
Area of Science:
- Cardiology
- Sleep Medicine
- Medical Devices
Background:
- Obstructive sleep apnoea syndrome (OSAS) is prevalent in patients with pacemakers.
- Atrial-synchronous ventricular pacemakers are used for bradyarrhythmias.
- The effect of atrial overdrive pacing on OSAS is not well understood.
Purpose of the Study:
- To evaluate the efficacy of atrial overdrive pacing in reducing OSAS severity.
- To assess the impact of atrial pacing on respiratory and sleep parameters in patients with pacemakers.
Main Methods:
- A crossover study design was used with 17 patients implanted with pacemakers.
- Patients underwent polysomnography with and without atrial overdrive pacing (15 bpm faster than baseline) during sleep.
- Three overnight polysomnographic evaluations were conducted one month apart.
Main Results:
- OSAS was highly prevalent, with 67% of patients (10/15) having an apnoea-hypopnoea index >30 events/h.
- Atrial overdrive pacing increased nocturnal heart rate from 59+/-7 bpm to 75+/-10 bpm.
- No significant differences were observed in apnoea-hypopnoea index, respiratory indices, or sleep parameters between spontaneous rhythm and overdrive pacing.
Conclusions:
- Atrial overdrive pacing does not significantly affect the severity of obstructive sleep apnoea.
- Current pacemaker algorithms with atrial overdrive pacing are not effective for managing OSAS in this patient population.