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Physiologic pacing in patients with obstructive sleep apnea: a prospective, randomized crossover trial
Andrew D Krahn1, Raymond Yee, Mark K Erickson
1Division of Cardiology, University of Western Ontario, London, Ontario, Canada. akrahn@uwo.ca
Journal of the American College of Cardiology
|January 18, 2006
Summary
Physiologic pacing did not significantly improve obstructive sleep apnea (OSA) severity in patients with pacemakers. This study found no significant changes in the apnea-hypopnea index or oxygen saturation with pacing, suggesting it may not be beneficial for OSA management.
Area of Science:
- Cardiology
- Pulmonology
- Sleep Medicine
Background:
- Sleep apnea involves heart rate changes during sleep.
- Pacemaker patients may experience fewer apnea events with faster pacing rates.
Purpose of the Study:
- To evaluate if preventing bradycardia with physiologic pacing impacts obstructive sleep apnea (OSA) severity.
- To assess the effect of temporary atrial pacing on the apnea-hypopnea index (AHI) in OSA patients.
Main Methods:
- A prospective, randomized, single-blind crossover trial was conducted.
- Fifteen patients with moderate to severe OSA underwent temporary atrial pacing and control sleep studies.
- Patients were blinded to pacing mode, and sleep recordings were analyzed blindly.
Main Results:
- Physiologic pacing did not significantly alter the apnea-hypopnea index (AHI) (p=0.23).
- No significant improvements were observed in desaturation time (p=0.70) or minimum SaO2 (p=0.38).
- A borderline significant reduction in circulatory time was noted with pacing (p=0.09).
Conclusions:
- Temporary atrial pacing does not appear to improve the respiratory aspects of obstructive sleep apnea.
- Permanent atrial pacing is not indicated for this patient group based on these findings.
